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 $117.49 Median $199.53 Typical High $7,413.10 | Facility | None | $117.49 | $199.53 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $269.15 | Professional | None | $117.49 | $199.53 | $269.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,819.70 | Facility | None | $912.01 | $1,348.96 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $549.54 | Professional | None | $181.97 | $288.40 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,202.26 Typical High $1,479.11 | Facility | None | $457.09 | $1,202.26 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $426.58 | Professional | None | $123.03 | $208.93 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $549.54 Typical High $1,071.52 | Facility | None | $199.53 | $549.54 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $331.13 | Professional | None | $190.55 | $251.19 | $331.13 |
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 $120.23 Median $194.98 Typical High $398.11 | Professional | None | $120.23 | $194.98 | $398.11 |
7 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 $58.88 Median $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $58.88 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $36.31 Typical High $42.66 | Professional | 53 · Discontinued | $23.44 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $138.04 Typical High $158.49 | Professional | 54 · Surgery only | $87.10 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $27.54 Typical High $31.62 | Professional | 55 · Aftercare only | $17.38 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $11.75 | $18.20 | $21.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $346.74 Typical High $724.44 | Facility | 51 · Multiple procedures | $186.21 | $346.74 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $125.89 Typical High $275.42 | Professional | 51 · Multiple procedures | $95.50 | $125.89 | $275.42 |
Where North Carolina sits
The same service costs 4.0 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· 17th of 51
$263
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.