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 $46.77 Median $125.89 Typical High $4,265.80 | Facility | None | $46.77 | $125.89 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $114.82 Typical High $151.36 | Professional | None | $46.77 | $114.82 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $104.71 | Professional | None | $85.11 | $85.11 | $104.71 |
BCBS North Carolina Setting Facility Modifier None Typical Low $87.10 Median $138.04 Typical High $346.74 | Facility | None | $87.10 | $138.04 | $346.74 |
BCBS North Carolina Setting Professional Modifier None Typical Low $72.44 Median $199.53 Typical High $338.84 | Professional | None | $72.44 | $199.53 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $218.78 Typical High $524.81 | Facility | None | $141.25 | $218.78 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $83.18 Typical High $190.55 | Professional | None | $30.20 | $83.18 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $309.03 | Professional | None | $123.03 | $123.03 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $107.15 Median $165.96 Typical High $218.78 | Facility | None | $107.15 | $165.96 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $144.54 | Professional | None | $97.72 | $120.23 | $144.54 |
Oscar Health Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $72.44 | Professional | None | $67.61 | $67.61 | $72.44 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $33.88 Median $87.10 Typical High $165.96 | Professional | None | $33.88 | $87.10 | $165.96 |
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 $23.44 Median $50.12 Typical High $64.57 | Professional | 52 · Reduced service | $23.44 | $50.12 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $19.95 Typical High $25.70 | Professional | 53 · Discontinued | $9.33 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $74.13 Typical High $97.72 | Professional | 54 · Surgery only | $34.67 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $15.14 Typical High $19.50 | Professional | 55 · Aftercare only | $6.92 | $15.14 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $10.00 Typical High $12.88 | Professional | 56 · Pre-op care only | $4.68 | $10.00 | $12.88 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $53.70 Median $83.18 Typical High $123.03 | Facility | 51 · Multiple procedures | $53.70 | $83.18 | $123.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $60.26 Typical High $81.28 | Professional | 51 · Multiple procedures | $48.98 | $60.26 | $81.28 |
Where North Carolina sits
The same service costs 3.5 times more in Alaska 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· 8th of 51
$155
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.