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 $38.90 Median $72.44 Typical High $5,248.07 | Facility | None | $38.90 | $72.44 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $72.44 Typical High $89.13 | Professional | None | $38.90 | $72.44 | $89.13 |
BCBS North Carolina Setting Facility Modifier None Typical Low $43.65 Median $63.10 Typical High $85.11 | Facility | None | $43.65 | $63.10 | $85.11 |
BCBS North Carolina Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $199.53 | Professional | None | $64.57 | $112.20 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $186.21 | Facility | None | $50.12 | $50.12 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $89.13 Typical High $151.36 | Professional | None | $46.77 | $89.13 | $151.36 |
Medcost Setting Facility Modifier None Typical Low $46.77 Median $72.44 Typical High $87.10 | Facility | None | $46.77 | $72.44 | $87.10 |
Medcost Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $120.23 | Professional | None | $69.18 | $95.50 | $120.23 |
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 $40.74 Median $70.79 Typical High $138.04 | Professional | None | $40.74 | $70.79 | $138.04 |
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 $19.50 Median $30.20 Typical High $38.02 | Professional | 52 · Reduced service | $19.50 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $12.30 Typical High $15.14 | Professional | 53 · Discontinued | $7.76 | $12.30 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $45.71 Typical High $57.54 | Professional | 54 · Surgery only | $29.51 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $9.12 Typical High $11.48 | Professional | 55 · Aftercare only | $5.89 | $9.12 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.03 Typical High $7.59 | Professional | 56 · Pre-op care only | $3.89 | $6.03 | $7.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $34.67 Median $47.86 Typical High $97.72 | Professional | 51 · Multiple procedures | $34.67 | $47.86 | $97.72 |
Where North Carolina sits
The same service costs 3.4 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· 15th of 51
$95.50
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.