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 $1,659.59 Typical High $7,585.78 | Facility | None | $371.54 | $1,659.59 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,548.82 Typical High $2,344.23 | Professional | None | $371.54 | $1,548.82 | $2,344.23 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $1,548.82 Typical High $2,089.30 | Facility | None | $1,047.13 | $1,548.82 | $2,089.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $645.65 Median $2,691.53 Typical High $5,370.32 | Professional | None | $645.65 | $2,691.53 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,511.89 Typical High $4,168.69 | Facility | None | $602.56 | $2,511.89 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $1,995.26 Typical High $3,388.44 | Professional | None | $467.74 | $1,995.26 | $3,388.44 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $1,412.54 Typical High $2,951.21 | Facility | None | $446.68 | $1,412.54 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $2,630.27 | Professional | None | $1,778.28 | $2,454.71 | $2,630.27 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $9,120.11 | Facility | None | $851.14 | $1,698.24 | $9,120.11 |
United Setting Professional Modifier None Typical Low $371.54 Median $1,318.26 Typical High $3,388.44 | Professional | None | $371.54 | $1,318.26 | $3,388.44 |
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 $186.21 Median $758.58 Typical High $954.99 | Professional | 52 · Reduced service | $186.21 | $758.58 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $302.00 Typical High $389.05 | Professional | 53 · Discontinued | $74.13 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $1,148.15 Typical High $1,445.44 | Professional | 54 · Surgery only | $275.42 | $1,148.15 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $229.09 Typical High $288.40 | Professional | 55 · Aftercare only | $54.95 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $151.36 Typical High $190.55 | Professional | 56 · Pre-op care only | $37.15 | $151.36 | $190.55 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,122.02 Median $1,230.27 Typical High $2,398.83 | Professional | 51 · Multiple procedures | $1,122.02 | $1,230.27 | $2,398.83 |
Where North Carolina sits
The same service costs 3.6 times more in Iowa than in Nebraska. 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· 13th of 51
$2,089
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.