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 $61.66 Median $165.96 Typical High $7,413.10 | Facility | None | $61.66 | $165.96 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $141.25 Typical High $177.83 | Professional | None | $61.66 | $141.25 | $177.83 |
BCBS North Carolina Setting Facility Modifier None Typical Low $87.10 Median $134.90 Typical High $346.74 | Facility | None | $87.10 | $134.90 | $346.74 |
BCBS North Carolina Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $389.05 | Professional | None | $107.15 | $190.55 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $269.15 Typical High $645.65 | Facility | None | $173.78 | $269.15 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $251.19 | Professional | None | $100.00 | $173.78 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $398.11 | Professional | None | $275.42 | $275.42 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $104.71 Median $239.88 Typical High $724.44 | Facility | None | $104.71 | $239.88 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $223.87 | Professional | None | $151.36 | $181.97 | $223.87 |
Oscar Health Setting Professional Modifier None Typical Low $93.33 Median $169.82 Typical High $263.03 | Professional | None | $93.33 | $169.82 | $263.03 |
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 $61.66 Median $125.89 Typical High $218.78 | Professional | None | $61.66 | $125.89 | $218.78 |
8 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 $30.90 Median $60.26 Typical High $83.18 | Professional | 52 · Reduced service | $30.90 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $23.99 Typical High $33.11 | Professional | 53 · Discontinued | $12.30 | $23.99 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $89.13 Typical High $125.89 | Professional | 54 · Surgery only | $46.77 | $89.13 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $17.78 Typical High $25.12 | Professional | 55 · Aftercare only | $9.33 | $17.78 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $12.02 Typical High $16.60 | Professional | 56 · Pre-op care only | $6.17 | $12.02 | $16.60 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 78 · Unplanned return to OR | $64.57 | $64.57 | $64.57 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $51.29 Median $134.90 Typical High $363.08 | Facility | 51 · Multiple procedures | $51.29 | $134.90 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $91.20 Typical High $120.23 | Professional | 51 · Multiple procedures | $74.13 | $91.20 | $120.23 |
Where North Carolina sits
The same service costs 3.7 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· 12th of 51
$178
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.