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 $107.15 Median $218.78 Typical High $7,413.10 | Facility | None | $107.15 | $218.78 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $213.80 Typical High $239.88 | Professional | None | $107.15 | $213.80 | $239.88 |
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 $165.96 Median $302.00 Typical High $588.84 | Professional | None | $165.96 | $302.00 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,071.52 Typical High $1,348.96 | Facility | None | $457.09 | $1,071.52 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $346.74 | Professional | None | $100.00 | $173.78 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $512.86 | Professional | None | $245.47 | $245.47 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $478.63 Typical High $933.25 | Facility | None | $218.78 | $478.63 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $263.03 | Professional | None | $162.18 | $208.93 | $263.03 |
Oscar Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $158.49 | Professional | None | $147.91 | $147.91 | $158.49 |
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 $95.50 Median $181.97 Typical High $281.84 | Professional | None | $95.50 | $181.97 | $281.84 |
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 $53.70 Median $95.50 Typical High $109.65 | Professional | 52 · Reduced service | $53.70 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $38.90 Typical High $43.65 | Professional | 53 · Discontinued | $21.38 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $144.54 Typical High $165.96 | Professional | 54 · Surgery only | $81.28 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $28.84 Typical High $33.11 | Professional | 55 · Aftercare only | $16.22 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $19.50 Typical High $21.88 | Professional | 56 · Pre-op care only | $10.72 | $19.50 | $21.88 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $257.04 Typical High $676.08 | Facility | 51 · Multiple procedures | $186.21 | $257.04 | $676.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $81.28 Median $112.20 Typical High $158.49 | Professional | 51 · Multiple procedures | $81.28 | $112.20 | $158.49 |
Where North Carolina sits
The same service costs 3.8 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· 11th of 51
$275
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.