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 $102.33 Median $138.04 Typical High $5,248.07 | Facility | None | $102.33 | $138.04 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $165.96 | Professional | None | $102.33 | $138.04 | $165.96 |
BCBS North Carolina Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $158.49 | Facility | None | $79.43 | $117.49 | $158.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $380.19 | Professional | None | $138.04 | $223.87 | $380.19 |
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 $102.33 Median $147.91 Typical High $316.23 | Professional | None | $102.33 | $147.91 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $354.81 | Facility | None | $66.07 | $102.33 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $234.42 | Professional | None | $134.90 | $162.18 | $234.42 |
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 $100.00 Median $138.04 Typical High $309.03 | Professional | None | $100.00 | $138.04 | $309.03 |
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 $50.12 Median $67.61 Typical High $72.44 | Professional | 52 · Reduced service | $50.12 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $27.54 Typical High $29.51 | Professional | 53 · Discontinued | $20.42 | $27.54 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $102.33 Typical High $109.65 | Professional | 54 · Surgery only | $75.86 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $20.42 Typical High $21.88 | Professional | 55 · Aftercare only | $15.14 | $20.42 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.80 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.23 | $13.80 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $95.50 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $70.79 | $95.50 | $102.33 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $33.11 Median $51.29 Typical High $51.29 | Facility | 51 · Multiple procedures | $33.11 | $51.29 | $51.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $67.61 Median $91.20 Typical High $186.21 | Professional | 51 · Multiple procedures | $67.61 | $91.20 | $186.21 |
Where North Carolina sits
The same service costs 4.2 times more in Alaska 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· 20th of 51
$178
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.