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 $81.28 Median $117.49 Typical High $1,584.89 | Facility | None | $81.28 | $117.49 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $144.54 | Professional | None | $81.28 | $117.49 | $144.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $128.82 | Facility | None | $63.10 | $93.33 | $128.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $338.84 | Professional | None | $134.90 | $204.17 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $120.23 Typical High $181.97 | Facility | None | $56.23 | $120.23 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $263.03 | Professional | None | $95.50 | $154.88 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $107.15 Typical High $165.96 | Facility | None | $74.13 | $107.15 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $194.98 | Professional | None | $112.20 | $158.49 | $194.98 |
United Setting Facility Modifier None Typical Low $295.12 Median $524.81 Typical High $2,818.38 | Facility | None | $295.12 | $524.81 | $2,818.38 |
United Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $269.15 | Professional | None | $85.11 | $128.82 | $269.15 |
9 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 $40.74 Median $54.95 Typical High $63.10 | Professional | 52 · Reduced service | $40.74 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $22.39 Typical High $25.12 | Professional | 53 · Discontinued | $16.60 | $22.39 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $83.18 Typical High $93.33 | Professional | 54 · Surgery only | $61.66 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.60 Typical High $18.62 | Professional | 55 · Aftercare only | $12.30 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.96 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.13 | $10.96 | $12.59 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $104.71 Median $162.18 Typical High $251.19 | Facility | 50 · Both sides | $104.71 | $162.18 | $251.19 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $34.67 Median $53.70 Typical High $83.18 | Facility | 51 · Multiple procedures | $34.67 | $53.70 | $83.18 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $251.19 Typical High $501.19 | Professional | 50 · Both sides | $169.82 | $251.19 | $501.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $56.23 Median $83.18 Typical High $165.96 | Professional | 51 · Multiple procedures | $56.23 | $83.18 | $165.96 |
Where North Carolina sits
The same service costs 3.2 times more in Wisconsin 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· 9th of 51
$182
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.