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 $912.01 Median $1,288.25 Typical High $8,317.64 | Facility | None | $912.01 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,122.02 | Professional | None | $912.01 | $912.01 | $1,122.02 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,023.29 | $1,819.70 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $2,454.71 | Professional | None | $1,000.00 | $1,288.25 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,071.52 Typical High $3,801.89 | Facility | None | $912.01 | $1,071.52 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,258.93 | $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 $912.01 Median $1,148.15 Typical High $2,238.72 | Professional | None | $912.01 | $1,148.15 | $2,238.72 |
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 $446.68 Median $446.68 Typical High $562.34 | Professional | 52 · Reduced service | $446.68 | $446.68 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $223.87 | Professional | 53 · Discontinued | $181.97 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $831.76 | Professional | 54 · Surgery only | $676.08 | $676.08 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $169.82 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $776.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $1,905.46 Typical High $3,981.07 | Professional | 50 · Both sides | $1,819.70 | $1,905.46 | $3,981.07 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $602.56 Median $630.96 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $602.56 | $630.96 | $1,318.26 |
Where North Carolina sits
The same service costs 5.6 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· 21st of 51
$1,349
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.