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 $131.83 Median $1,000.00 Typical High $7,943.28 | Facility | None | $131.83 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $169.82 | Professional | None | $131.83 | $131.83 | $169.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $912.01 | Facility | None | $446.68 | $676.08 | $912.01 |
BCBS North Carolina Setting Professional Modifier None Typical Low $120.23 Median $371.54 Typical High $616.60 | Professional | None | $120.23 | $371.54 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,318.26 Typical High $1,778.28 | Facility | None | $457.09 | $1,318.26 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $346.74 | Professional | None | $190.55 | $245.47 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $363.08 | Professional | None | $309.03 | $363.08 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $446.68 Typical High $1,258.93 | Facility | None | $371.54 | $446.68 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $263.03 Typical High $323.59 | Professional | None | $125.89 | $263.03 | $323.59 |
Oscar Health Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $295.12 | Professional | None | $281.84 | $281.84 | $295.12 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $302.00 | Professional | None | $128.82 | $204.17 | $302.00 |
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 $66.07 Median $66.07 Typical High $79.43 | Professional | 52 · Reduced service | $66.07 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $31.62 | Professional | 53 · Discontinued | $26.30 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $120.23 | Professional | 54 · Surgery only | $97.72 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $23.99 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $15.85 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $15.85 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $223.87 Typical High $851.14 | Facility | 51 · Multiple procedures | $186.21 | $223.87 | $851.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $144.54 Typical High $194.98 | Professional | 51 · Multiple procedures | $63.10 | $144.54 | $194.98 |
Where North Carolina sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 8th of 51
$302
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.