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 $51.29 Median $83.18 Typical High $7,413.10 | Facility | None | $51.29 | $83.18 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $83.18 Typical High $100.00 | Professional | None | $51.29 | $83.18 | $100.00 |
BCBS North Carolina Setting Facility Modifier None Typical Low $44.67 Median $69.18 Typical High $177.83 | Facility | None | $44.67 | $69.18 | $177.83 |
BCBS North Carolina Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $234.42 | Professional | None | $85.11 | $147.91 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $416.87 Typical High $870.96 | Facility | None | $346.74 | $416.87 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $181.97 | Professional | None | $61.66 | $100.00 | $181.97 |
Medcost Setting Facility Modifier None Typical Low $47.86 Median $74.13 Typical High $100.00 | Facility | None | $47.86 | $74.13 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $138.04 | Professional | None | $79.43 | $112.20 | $138.04 |
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 $53.70 Median $87.10 Typical High $181.97 | Professional | None | $53.70 | $87.10 | $181.97 |
6 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 $25.70 Median $35.48 Typical High $44.67 | Professional | 52 · Reduced service | $25.70 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $14.13 Typical High $17.78 | Professional | 53 · Discontinued | $10.23 | $14.13 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $52.48 Typical High $67.61 | Professional | 54 · Surgery only | $38.90 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.47 Typical High $13.49 | Professional | 55 · Aftercare only | $7.76 | $10.47 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $7.08 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.13 | $7.08 | $8.91 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $39.81 Median $54.95 Typical High $112.20 | Professional | 51 · Multiple procedures | $39.81 | $54.95 | $112.20 |
Where North Carolina sits
The same service costs 3.5 times more in Wisconsin than in New York. 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· 10th of 51
$126
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.