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 $416.87 Median $1,148.15 Typical High $7,943.28 | Facility | None | $416.87 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $758.58 | Professional | None | $416.87 | $416.87 | $758.58 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $3,467.37 | Facility | None | $1,737.80 | $2,570.40 | $3,467.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $309.03 Median $831.76 Typical High $1,258.93 | Professional | None | $309.03 | $831.76 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,290.87 Typical High $3,388.44 | Facility | None | $602.56 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $1,122.02 | Professional | None | $457.09 | $588.84 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $977.24 Typical High $2,511.89 | Facility | None | $512.86 | $977.24 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $691.83 | Professional | None | $478.63 | $575.44 | $691.83 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $1,047.13 | Professional | None | $416.87 | $524.81 | $1,047.13 |
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 $208.93 Median $208.93 Typical High $257.04 | Professional | 52 · Reduced service | $208.93 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $102.33 | Professional | 53 · Discontinued | $83.18 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $389.05 | Professional | 54 · Surgery only | $309.03 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $77.62 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $51.29 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $363.08 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $724.44 Typical High $1,258.93 | Facility | 51 · Multiple procedures | $263.03 | $724.44 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $288.40 Typical High $602.56 | Professional | 51 · Multiple procedures | $275.42 | $288.40 | $602.56 |
Where North Carolina sits
The same service costs 8.9 times more in Oklahoma 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
$724
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.