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 $954.99 Typical High $7,413.10 | Facility | None | $83.18 | $954.99 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $724.44 Typical High $977.24 | Professional | None | $83.18 | $724.44 | $977.24 |
BCBS North Carolina Setting Facility Modifier None Typical Low $602.56 Median $933.25 Typical High $2,398.83 | Facility | None | $602.56 | $933.25 | $2,398.83 |
BCBS North Carolina Setting Professional Modifier None Typical Low $123.03 Median $741.31 Typical High $2,570.40 | Professional | None | $123.03 | $741.31 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $977.24 Typical High $1,584.89 | Facility | None | $416.87 | $977.24 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $676.08 Typical High $1,412.54 | Professional | None | $35.48 | $676.08 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $2,398.83 | Professional | None | $1,047.13 | $1,047.13 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $691.83 Typical High $1,348.96 | Facility | None | $436.52 | $691.83 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $891.25 Typical High $1,023.29 | Professional | None | $97.72 | $891.25 | $1,023.29 |
Oscar Health Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $83.18 | Professional | None | $77.62 | $77.62 | $83.18 |
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 $39.81 Median $575.44 Typical High $1,202.26 | Professional | None | $39.81 | $575.44 | $1,202.26 |
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 $398.11 Typical High $478.63 | Professional | 52 · Reduced service | $41.69 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $158.49 Typical High $190.55 | Professional | 53 · Discontinued | $16.60 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $602.56 Typical High $724.44 | Professional | 54 · Surgery only | $61.66 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $12.30 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $79.43 Typical High $95.50 | Professional | 56 · Pre-op care only | $8.32 | $79.43 | $95.50 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $218.78 Median $338.84 Typical High $676.08 | Facility | 51 · Multiple procedures | $218.78 | $338.84 | $676.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $446.68 Typical High $512.86 | Professional | 51 · Multiple procedures | $48.98 | $446.68 | $512.86 |
Where North Carolina sits
The same service costs 14.1 times more in Washington than in Kentucky. 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· 27th of 51
$741
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.