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 $812.83 Median $1,288.25 Typical High $8,317.64 | Facility | None | $812.83 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,023.29 | Professional | None | $812.83 | $812.83 | $1,023.29 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,754.23 Typical High $7,079.46 | Facility | None | $1,778.28 | $2,754.23 | $7,079.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,621.81 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,630.78 Typical High $5,370.32 | Facility | None | $645.65 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $2,187.76 | Professional | None | $933.25 | $1,174.90 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,445.44 Typical High $3,801.89 | Facility | None | $602.56 | $1,445.44 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,479.11 | Professional | None | $977.24 | $1,122.02 | $1,479.11 |
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 $831.76 Median $1,023.29 Typical High $2,041.74 | Professional | None | $831.76 | $1,023.29 | $2,041.74 |
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 $407.38 Median $407.38 Typical High $512.86 | Professional | 52 · Reduced service | $407.38 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $204.17 | Professional | 53 · Discontinued | $165.96 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $758.58 | Professional | 54 · Surgery only | $616.60 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $154.88 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $102.33 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $707.95 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $724.44 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $295.12 | $724.44 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $549.54 Typical High $1,202.26 | Professional | 51 · Multiple procedures | $549.54 | $549.54 | $1,202.26 |
Where North Carolina sits
The same service costs 5.9 times more in Alaska than in Texas. 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· 15th of 51
$1,549
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.