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 $371.54 Median $1,380.38 Typical High $7,585.78 | Facility | None | $371.54 | $1,380.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,288.25 Typical High $1,659.59 | Professional | None | $371.54 | $1,288.25 | $1,659.59 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $3,235.94 | Facility | None | $1,621.81 | $2,398.83 | $3,235.94 |
BCBS North Carolina Setting Professional Modifier None Typical Low $831.76 Median $3,630.78 Typical High $6,606.93 | Professional | None | $831.76 | $3,630.78 | $6,606.93 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,818.38 | Facility | None | $602.56 | $1,778.28 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $1,905.46 Typical High $4,168.69 | Professional | None | $575.44 | $1,905.46 | $4,168.69 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $2,398.83 Typical High $3,630.78 | Facility | None | $1,548.82 | $2,398.83 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $2,884.03 Typical High $3,090.30 | Professional | None | $1,288.25 | $2,884.03 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $407.38 Median $1,318.26 Typical High $4,073.80 | Professional | None | $407.38 | $1,318.26 | $4,073.80 |
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 $186.21 Median $562.34 Typical High $794.33 | Professional | 52 · Reduced service | $186.21 | $562.34 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $223.87 Typical High $316.23 | Professional | 53 · Discontinued | $74.13 | $223.87 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $831.76 Typical High $1,174.90 | Professional | 54 · Surgery only | $275.42 | $831.76 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $165.96 Typical High $234.42 | Professional | 55 · Aftercare only | $54.95 | $165.96 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $112.20 Typical High $158.49 | Professional | 56 · Pre-op care only | $37.15 | $112.20 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $776.25 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $257.04 | $776.25 | $1,096.48 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $831.76 Median $1,288.25 Typical High $1,819.70 | Facility | 51 · Multiple procedures | $831.76 | $1,288.25 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $1,479.11 Typical High $2,041.74 | Professional | 51 · Multiple procedures | $645.65 | $1,479.11 | $2,041.74 |
Where North Carolina sits
The same service costs 4.9 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· 6th of 51
$2,188
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.