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 $1,000.00 Median $1,148.15 Typical High $7,943.28 | Facility | None | $1,000.00 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,230.27 | Professional | None | $1,000.00 | $1,000.00 | $1,230.27 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,754.23 | Facility | None | $1,318.26 | $1,949.84 | $2,754.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,380.38 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,380.38 | $1,949.84 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $2,398.83 | Facility | None | $602.56 | $1,513.56 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,630.27 | Professional | None | $1,023.29 | $1,380.38 | $2,630.27 |
Medcost Setting Facility Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $3,019.95 | Facility | None | $1,047.13 | $1,584.89 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,348.96 | $1,659.59 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $2,454.71 | Professional | None | $1,000.00 | $1,258.93 | $2,454.71 |
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 $489.78 Median $489.78 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $245.47 | Professional | 53 · Discontinued | $199.53 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $933.25 | Professional | 54 · Surgery only | $741.31 | $741.31 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $186.21 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $123.03 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $870.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $676.08 Typical High $1,445.44 | Professional | 51 · Multiple procedures | $588.84 | $676.08 | $1,445.44 |
Where North Carolina sits
The same service costs 5.9 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· 20th of 51
$1,514
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.