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 $204.17 Median $851.14 Typical High $7,585.78 | Facility | None | $204.17 | $851.14 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $776.25 Typical High $933.25 | Professional | None | $204.17 | $776.25 | $933.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $407.38 Median $1,380.38 Typical High $2,290.87 | Professional | None | $407.38 | $1,380.38 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $741.31 Typical High $1,737.80 | Professional | None | $275.42 | $741.31 | $1,737.80 |
Medcost Setting Facility Modifier None Typical Low $204.17 Median $208.93 Typical High $912.01 | Facility | None | $204.17 | $208.93 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,778.28 | Professional | None | $912.01 | $1,096.48 | $1,778.28 |
Oscar Health Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
United Setting Facility Modifier None Typical Low $6,456.54 Median $10,964.78 Typical High $16,982.44 | Facility | None | $6,456.54 | $10,964.78 | $16,982.44 |
United Setting Professional Modifier None Typical Low $213.80 Median $776.25 Typical High $1,659.59 | Professional | None | $213.80 | $776.25 | $1,659.59 |
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 $102.33 Median $354.81 Typical High $457.09 | Professional | 52 · Reduced service | $102.33 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $144.54 Typical High $181.97 | Professional | 53 · Discontinued | $40.74 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $537.03 Typical High $676.08 | Professional | 54 · Surgery only | $154.88 | $537.03 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $107.15 Typical High $134.90 | Professional | 55 · Aftercare only | $30.90 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $70.79 Typical High $91.20 | Professional | 56 · Pre-op care only | $20.42 | $70.79 | $91.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $549.54 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $549.54 | $549.54 | $1,174.90 |
Where North Carolina sits
The same service costs 5.4 times more in Wisconsin than in Maryland. 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· 5th of 51
$1,096
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.