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 $61.66 Median $87.10 Typical High $7,413.10 | Facility | None | $61.66 | $87.10 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $107.15 | Professional | None | $61.66 | $87.10 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $95.50 | Professional | None | $42.66 | $42.66 | $95.50 |
BCBS North Carolina Setting Facility Modifier None Typical Low $38.02 Median $56.23 Typical High $75.86 | Facility | None | $38.02 | $56.23 | $75.86 |
BCBS North Carolina Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $239.88 | Professional | None | $100.00 | $151.36 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $87.10 Typical High $524.81 | Facility | None | $54.95 | $87.10 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $194.98 | Professional | None | $75.86 | $104.71 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $63.10 Typical High $123.03 | Facility | None | $43.65 | $63.10 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $144.54 | Professional | None | $83.18 | $114.82 | $144.54 |
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 $63.10 Median $100.00 Typical High $204.17 | Professional | None | $63.10 | $100.00 | $204.17 |
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 $30.90 Median $38.90 Typical High $45.71 | Professional | 52 · Reduced service | $30.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $15.85 Typical High $18.62 | Professional | 53 · Discontinued | $12.30 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $58.88 Typical High $69.18 | Professional | 54 · Surgery only | $45.71 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $11.75 Typical High $13.80 | Professional | 55 · Aftercare only | $9.33 | $11.75 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.76 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.17 | $7.76 | $9.33 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $20.42 Median $31.62 Typical High $50.12 | Facility | 51 · Multiple procedures | $20.42 | $31.62 | $50.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $46.77 Median $60.26 Typical High $120.23 | Professional | 51 · Multiple procedures | $46.77 | $60.26 | $120.23 |
Where North Carolina sits
The same service costs 3.5 times more in Wisconsin than in Florida. 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· 12th of 51
$132
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.