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 $77.62 Median $131.83 Typical High $7,413.10 | Facility | None | $77.62 | $131.83 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $131.83 Typical High $190.55 | Professional | None | $77.62 | $131.83 | $190.55 |
BCBS North Carolina Setting Facility Modifier None Typical Low $331.13 Median $489.78 Typical High $660.69 | Facility | None | $331.13 | $489.78 | $660.69 |
BCBS North Carolina Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $398.11 | Professional | None | $134.90 | $218.78 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $537.03 Typical High $1,318.26 | Facility | None | $363.08 | $537.03 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $186.21 Typical High $295.12 | Professional | None | $102.33 | $186.21 | $295.12 |
Medcost Setting Facility Modifier None Typical Low $158.49 Median $389.05 Typical High $776.25 | Facility | None | $158.49 | $389.05 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $257.04 | Professional | None | $128.82 | $204.17 | $257.04 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $79.43 Median $144.54 Typical High $275.42 | Professional | None | $79.43 | $144.54 | $275.42 |
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 $38.90 Median $60.26 Typical High $70.79 | Professional | 52 · Reduced service | $38.90 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $23.99 Typical High $28.18 | Professional | 53 · Discontinued | $15.49 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $91.20 Typical High $107.15 | Professional | 54 · Surgery only | $57.54 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $18.20 Typical High $21.38 | Professional | 55 · Aftercare only | $11.48 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $12.02 Typical High $14.13 | Professional | 56 · Pre-op care only | $7.76 | $12.02 | $14.13 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $134.90 Median $204.17 Typical High $389.05 | Facility | 51 · Multiple procedures | $134.90 | $204.17 | $389.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $120.23 Typical High $186.21 | Professional | 51 · Multiple procedures | $63.10 | $120.23 | $186.21 |
Where North Carolina sits
The same service costs 3.6 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· 11th of 51
$204
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.