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 $851.14 Median $1,000.00 Typical High $7,943.28 | Facility | None | $851.14 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,122.02 | Professional | None | $851.14 | $851.14 | $1,122.02 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $4,466.84 | Facility | None | $1,122.02 | $1,698.24 | $4,466.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,148.15 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,659.59 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,890.45 Typical High $6,456.54 | Facility | None | $602.56 | $3,890.45 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $2,290.87 | Professional | None | $954.99 | $1,230.27 | $2,290.87 |
Medcost Setting Facility Modifier None Typical Low $870.96 Median $1,348.96 Typical High $3,801.89 | Facility | None | $870.96 | $1,348.96 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,412.54 | Professional | None | $977.24 | $1,202.26 | $1,412.54 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $2,137.96 | Professional | None | $812.83 | $1,047.13 | $2,137.96 |
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 $426.58 Median $426.58 Typical High $512.86 | Professional | 52 · Reduced service | $426.58 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $204.17 | Professional | 53 · Discontinued | $169.82 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $776.25 | Professional | 54 · Surgery only | $645.65 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $724.44 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $436.52 Median $676.08 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $436.52 | $676.08 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $602.56 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $512.86 | $602.56 | $1,258.93 |
Where North Carolina sits
The same service costs 5.8 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· 18th of 51
$1,349
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.