How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $81.28 Median $190.55 Typical High $7,413.10 | Facility | None | $81.28 | $190.55 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $190.55 Typical High $218.78 | Professional | None | $81.28 | $190.55 | $218.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $501.19 Median $776.25 Typical High $1,995.26 | Facility | None | $501.19 | $776.25 | $1,995.26 |
BCBS North Carolina Setting Professional Modifier None Typical Low $138.04 Median $245.47 Typical High $549.54 | Professional | None | $138.04 | $245.47 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $263.03 Typical High $645.65 | Facility | None | $165.96 | $263.03 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $213.80 Typical High $309.03 | Professional | None | $100.00 | $213.80 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $426.58 Typical High $724.44 | Facility | None | $190.55 | $426.58 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $245.47 | Professional | None | $181.97 | $245.47 | $245.47 |
United Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
United Setting Professional Modifier None Typical Low $79.43 Median $165.96 Typical High $275.42 | Professional | None | $79.43 | $165.96 | $275.42 |
7 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $85.11 Typical High $97.72 | Professional | 52 · Reduced service | $40.74 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $34.67 Typical High $38.90 | Professional | 53 · Discontinued | $16.22 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $128.82 Typical High $144.54 | Professional | 54 · Surgery only | $60.26 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $25.70 Typical High $29.51 | Professional | 55 · Aftercare only | $12.02 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $16.98 Typical High $19.50 | Professional | 56 · Pre-op care only | $8.13 | $16.98 | $19.50 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $104.71 Median $234.42 Typical High $363.08 | Facility | 51 · Multiple procedures | $104.71 | $234.42 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $89.13 Median $123.03 Typical High $169.82 | Professional | 51 · Multiple procedures | $89.13 | $123.03 | $169.82 |
Where North Carolina sits
The same service costs 3.7 times more in Alaska than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
North Carolina· 9th of 51
$240
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.