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 $38.90 Median $158.49 Typical High $7,413.10 | Facility | None | $38.90 | $158.49 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $151.36 Typical High $173.78 | Professional | None | $38.90 | $151.36 | $173.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $81.28 Median $120.23 Typical High $158.49 | Facility | None | $81.28 | $120.23 | $158.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $54.95 Median $181.97 Typical High $407.38 | Professional | None | $54.95 | $181.97 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $186.21 | Facility | None | $50.12 | $50.12 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $95.50 Typical High $234.42 | Professional | None | $41.69 | $95.50 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $398.11 | Professional | None | $147.91 | $147.91 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $46.77 Median $102.33 Typical High $158.49 | Facility | None | $46.77 | $102.33 | $158.49 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $151.36 Typical High $158.49 | Professional | None | $64.57 | $151.36 | $158.49 |
Oscar Health Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $61.66 | Professional | None | $57.54 | $57.54 | $61.66 |
United Setting Facility Modifier None Typical Low $295.12 Median $524.81 Typical High $2,818.38 | Facility | None | $295.12 | $524.81 | $2,818.38 |
United Setting Professional Modifier None Typical Low $38.02 Median $97.72 Typical High $190.55 | Professional | None | $38.02 | $97.72 | $190.55 |
6 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 $19.50 Median $57.54 Typical High $81.28 | Professional | 52 · Reduced service | $19.50 | $57.54 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $23.44 Typical High $32.36 | Professional | 53 · Discontinued | $7.76 | $23.44 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $87.10 Typical High $120.23 | Professional | 54 · Surgery only | $29.51 | $87.10 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $17.38 Typical High $24.55 | Professional | 55 · Aftercare only | $5.89 | $17.38 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $11.75 Typical High $16.22 | Professional | 56 · Pre-op care only | $3.89 | $11.75 | $16.22 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $32.36 Median $75.86 Typical High $77.62 | Professional | 51 · Multiple procedures | $32.36 | $75.86 | $77.62 |
Where North Carolina sits
The same service costs 4.6 times more in Wisconsin 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· 13th of 51
$158
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.