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 $70.79 Median $162.18 Typical High $7,413.10 | Facility | None | $70.79 | $162.18 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $131.83 Typical High $165.96 | Professional | None | $70.79 | $131.83 | $165.96 |
BCBS North Carolina Setting Facility Modifier None Typical Low $58.88 Median $87.10 Typical High $120.23 | Facility | None | $58.88 | $87.10 | $120.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $316.23 | Professional | None | $117.49 | $181.97 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $218.78 Typical High $524.81 | Facility | None | $138.04 | $218.78 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $151.36 Typical High $275.42 | Professional | None | $85.11 | $151.36 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $67.61 Median $100.00 Typical High $199.53 | Facility | None | $67.61 | $100.00 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $154.88 Typical High $263.03 | Professional | None | $151.36 | $154.88 | $263.03 |
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 $72.44 Median $134.90 Typical High $257.04 | Professional | None | $72.44 | $134.90 | $257.04 |
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 $35.48 Median $48.98 Typical High $81.28 | Professional | 52 · Reduced service | $35.48 | $48.98 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $19.50 Typical High $32.36 | Professional | 53 · Discontinued | $14.13 | $19.50 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $72.44 Typical High $120.23 | Professional | 54 · Surgery only | $52.48 | $72.44 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $14.45 Typical High $23.99 | Professional | 55 · Aftercare only | $10.47 | $14.45 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $9.77 Typical High $16.22 | Professional | 56 · Pre-op care only | $7.08 | $9.77 | $16.22 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $31.62 Median $50.12 Typical High $100.00 | Facility | 51 · Multiple procedures | $31.62 | $50.12 | $100.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $75.86 Typical High $194.98 | Professional | 51 · Multiple procedures | $75.86 | $75.86 | $194.98 |
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· 16th of 51
$170
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.