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 $204.17 Typical High $7,413.10 | Facility | None | $83.18 | $204.17 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $190.55 Typical High $218.78 | Professional | None | $83.18 | $190.55 | $218.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $588.84 Median $870.96 Typical High $1,174.90 | Facility | None | $588.84 | $870.96 | $1,174.90 |
BCBS North Carolina Setting Professional Modifier None Typical Low $104.71 Median $234.42 Typical High $501.19 | Professional | None | $104.71 | $234.42 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,905.46 Typical High $2,818.38 | Facility | None | $457.09 | $1,905.46 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $123.03 Typical High $295.12 | Professional | None | $58.88 | $123.03 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $489.78 | Professional | None | $208.93 | $208.93 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $446.68 Typical High $2,041.74 | Facility | None | $199.53 | $446.68 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $229.09 | Professional | None | $114.82 | $190.55 | $229.09 |
Oscar Health Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $112.20 | Professional | None | $107.15 | $107.15 | $112.20 |
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 $64.57 Median $138.04 Typical High $251.19 | Professional | None | $64.57 | $138.04 | $251.19 |
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 $40.74 Median $83.18 Typical High $102.33 | Professional | 52 · Reduced service | $40.74 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $33.11 Typical High $40.74 | Professional | 53 · Discontinued | $16.60 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $123.03 Typical High $151.36 | Professional | 54 · Surgery only | $61.66 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $25.12 Typical High $30.90 | Professional | 55 · Aftercare only | $12.30 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $16.60 Typical High $20.42 | Professional | 56 · Pre-op care only | $8.32 | $16.60 | $20.42 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $251.19 Typical High $1,513.56 | Facility | 51 · Multiple procedures | $186.21 | $251.19 | $1,513.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $95.50 Typical High $144.54 | Professional | 51 · Multiple procedures | $57.54 | $95.50 | $144.54 |
Where North Carolina sits
The same service costs 4.5 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· 14th of 51
$209
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.