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 $114.82 Median $1,000.00 Typical High $7,943.28 | Facility | None | $114.82 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $144.54 | Professional | None | $114.82 | $114.82 | $144.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $6,309.57 | Facility | None | $1,584.89 | $2,511.89 | $6,309.57 |
BCBS North Carolina Setting Professional Modifier None Typical Low $53.70 Median $234.42 Typical High $346.74 | Professional | None | $53.70 | $234.42 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $5,888.44 Typical High $8,709.64 | Facility | None | $457.09 | $5,888.44 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $112.20 Typical High $245.47 | Professional | None | $107.15 | $112.20 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $269.15 | Professional | None | $162.18 | $162.18 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $346.74 Median $602.56 Typical High $5,128.61 | Facility | None | $346.74 | $602.56 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $154.88 | Professional | None | $109.65 | $123.03 | $154.88 |
Oscar Health Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $109.65 | Professional | None | $104.71 | $104.71 | $109.65 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $218.78 | Professional | None | $100.00 | $117.49 | $218.78 |
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 $57.54 Median $57.54 Typical High $67.61 | Professional | 52 · Reduced service | $57.54 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $26.92 | Professional | 53 · Discontinued | $22.91 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | 54 · Surgery only | $85.11 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $20.42 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $13.49 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $645.65 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $186.21 | $645.65 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $53.70 Median $61.66 Typical High $85.11 | Professional | 51 · Multiple procedures | $53.70 | $61.66 | $85.11 |
Where North Carolina sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 12th of 51
$204
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.