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 $346.74 Median $1,148.15 Typical High $7,943.28 | Facility | None | $346.74 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $426.58 | Professional | None | $346.74 | $346.74 | $426.58 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,630.27 | Facility | None | $1,318.26 | $1,949.84 | $2,630.27 |
BCBS North Carolina Setting Professional Modifier None Typical Low $323.59 Median $758.58 Typical High $1,174.90 | Professional | None | $323.59 | $758.58 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,479.11 Typical High $1,819.70 | Facility | None | $602.56 | $1,479.11 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $741.31 | Professional | None | $446.68 | $467.74 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $812.83 | Professional | None | $676.08 | $676.08 | $812.83 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $977.24 Typical High $2,511.89 | Facility | None | $512.86 | $977.24 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $602.56 | Professional | None | $331.13 | $501.19 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $457.09 | Professional | None | $436.52 | $436.52 | $457.09 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $691.83 | Professional | None | $331.13 | $436.52 | $691.83 |
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 $173.78 Median $173.78 Typical High $204.17 | Professional | 52 · Reduced service | $173.78 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | 53 · Discontinued | $69.18 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $309.03 | Professional | 54 · Surgery only | $263.03 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $61.66 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $40.74 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $40.74 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $537.03 Typical High $1,659.59 | Facility | 51 · Multiple procedures | $263.03 | $537.03 | $1,659.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $263.03 Typical High $323.59 | Professional | 51 · Multiple procedures | $165.96 | $263.03 | $323.59 |
Where North Carolina sits
The same service costs 4.8 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· 9th of 51
$661
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.