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 $165.96 Median $213.80 Typical High $7,413.10 | Facility | None | $165.96 | $213.80 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $281.84 | Professional | None | $165.96 | $213.80 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,290.87 | Facility | None | $1,148.15 | $1,698.24 | $2,290.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $616.60 | Professional | None | $229.09 | $363.08 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,513.56 Typical High $2,238.72 | Facility | None | $457.09 | $1,513.56 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $512.86 | Professional | None | $165.96 | $245.47 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $251.19 Median $549.54 Typical High $1,548.82 | Facility | None | $251.19 | $549.54 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $426.58 | Professional | None | $257.04 | $295.12 | $426.58 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $501.19 | Professional | None | $165.96 | $234.42 | $501.19 |
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 $83.18 Median $107.15 Typical High $114.82 | Professional | 52 · Reduced service | $83.18 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $42.66 Typical High $45.71 | Professional | 53 · Discontinued | $33.11 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $162.18 Typical High $173.78 | Professional | 54 · Surgery only | $123.03 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $32.36 Typical High $34.67 | Professional | 55 · Aftercare only | $24.55 | $32.36 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $21.38 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.60 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $151.36 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $114.82 | $151.36 | $162.18 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $436.52 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $186.21 | $436.52 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $138.04 Median $173.78 Typical High $309.03 | Professional | 51 · Multiple procedures | $138.04 | $173.78 | $309.03 |
Where North Carolina sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 14th of 51
$331
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.