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 $83.18 Median $338.84 Typical High $7,413.10 | Facility | None | $83.18 | $338.84 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $331.13 Typical High $380.19 | Professional | None | $83.18 | $331.13 | $380.19 |
BCBS North Carolina Setting Facility Modifier None Typical Low $162.18 Median $251.19 Typical High $645.65 | Facility | None | $162.18 | $251.19 | $645.65 |
BCBS North Carolina Setting Professional Modifier None Typical Low $144.54 Median $309.03 Typical High $933.25 | Professional | None | $144.54 | $309.03 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $257.04 Typical High $645.65 | Facility | None | $162.18 | $257.04 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $281.84 Typical High $512.86 | Professional | None | $104.71 | $281.84 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $407.38 Typical High $724.44 | Facility | None | $125.89 | $407.38 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $446.68 | Professional | None | $316.23 | $446.68 | $446.68 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $83.18 Median $269.15 Typical High $467.74 | Professional | None | $83.18 | $269.15 | $467.74 |
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 $41.69 Median $147.91 Typical High $177.83 | Professional | 52 · Reduced service | $41.69 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $58.88 Typical High $72.44 | Professional | 53 · Discontinued | $16.60 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $223.87 Typical High $269.15 | Professional | 54 · Surgery only | $61.66 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $44.67 Typical High $53.70 | Professional | 55 · Aftercare only | $12.30 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $29.51 Typical High $35.48 | Professional | 56 · Pre-op care only | $8.32 | $29.51 | $35.48 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $63.10 Median $223.87 Typical High $363.08 | Facility | 51 · Multiple procedures | $63.10 | $223.87 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $223.87 Typical High $223.87 | Professional | 51 · Multiple procedures | $158.49 | $223.87 | $223.87 |
Where North Carolina sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 23rd of 51
$309
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.