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 $30.20 Median $74.13 Typical High $5,495.41 | Facility | None | $30.20 | $74.13 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $74.13 Typical High $125.89 | Professional | None | $30.20 | $74.13 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $43.65 Median $102.33 Typical High $131.83 | Professional | None | $43.65 | $102.33 | $131.83 |
BCBS North Carolina Setting Facility Modifier None Typical Low $51.29 Median $77.62 Typical High $204.17 | Facility | None | $51.29 | $77.62 | $204.17 |
BCBS North Carolina Setting Professional Modifier None Typical Low $60.26 Median $141.25 Typical High $239.88 | Professional | None | $60.26 | $141.25 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $93.33 Typical High $147.91 | Facility | None | $53.70 | $93.33 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $102.33 Typical High $158.49 | Professional | None | $45.71 | $102.33 | $158.49 |
Medcost Setting Facility Modifier None Typical Low $54.95 Median $85.11 Typical High $141.25 | Facility | None | $54.95 | $85.11 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $134.90 | Professional | None | $70.79 | $114.82 | $134.90 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $32.36 Median $72.44 Typical High $158.49 | Professional | None | $32.36 | $72.44 | $158.49 |
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 $15.14 Median $32.36 Typical High $39.81 | Professional | 52 · Reduced service | $15.14 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $12.88 Typical High $15.85 | Professional | 53 · Discontinued | $6.03 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $48.98 Typical High $60.26 | Professional | 54 · Surgery only | $22.39 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $9.77 Typical High $12.02 | Professional | 55 · Aftercare only | $4.47 | $9.77 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $6.46 Typical High $7.94 | Professional | 56 · Pre-op care only | $3.02 | $6.46 | $7.94 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $27.54 Median $42.66 Typical High $70.79 | Facility | 51 · Multiple procedures | $27.54 | $42.66 | $70.79 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $35.48 Median $57.54 Typical High $104.71 | Professional | 51 · Multiple procedures | $35.48 | $57.54 | $104.71 |
Where North Carolina sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 7th of 51
$110
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.