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 $50.12 Median $93.33 Typical High $5,248.07 | Facility | None | $50.12 | $93.33 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $93.33 Typical High $154.88 | Professional | None | $50.12 | $93.33 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $128.82 Typical High $147.91 | Professional | None | $64.57 | $128.82 | $147.91 |
BCBS North Carolina Setting Facility Modifier None Typical Low $53.70 Median $85.11 Typical High $213.80 | Facility | None | $53.70 | $85.11 | $213.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $97.72 Median $199.53 Typical High $302.00 | Professional | None | $97.72 | $199.53 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $125.89 Typical High $524.81 | Facility | None | $79.43 | $125.89 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $134.90 Typical High $199.53 | Professional | None | $74.13 | $134.90 | $199.53 |
Medcost Setting Facility Modifier None Typical Low $63.10 Median $97.72 Typical High $162.18 | Facility | None | $63.10 | $97.72 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $173.78 | Professional | None | $91.20 | $138.04 | $173.78 |
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 $52.48 Median $97.72 Typical High $186.21 | Professional | None | $52.48 | $97.72 | $186.21 |
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 $25.12 Median $42.66 Typical High $50.12 | Professional | 52 · Reduced service | $25.12 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $16.98 Typical High $19.95 | Professional | 53 · Discontinued | $10.00 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $64.57 Typical High $75.86 | Professional | 54 · Surgery only | $37.15 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.88 Typical High $15.14 | Professional | 55 · Aftercare only | $7.59 | $12.88 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $8.51 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.01 | $8.51 | $10.00 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $31.62 Median $48.98 Typical High $81.28 | Facility | 51 · Multiple procedures | $31.62 | $48.98 | $81.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $45.71 Median $74.13 Typical High $131.83 | Professional | 51 · Multiple procedures | $45.71 | $74.13 | $131.83 |
Where North Carolina sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 8th of 51
$145
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.