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 $138.04 Median $169.82 Typical High $7,413.10 | Facility | None | $138.04 | $169.82 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $204.17 | Professional | None | $138.04 | $169.82 | $204.17 |
BCBS North Carolina Setting Facility Modifier None Typical Low $79.43 Median $123.03 Typical High $316.23 | Facility | None | $79.43 | $123.03 | $316.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $158.49 Median $331.13 Typical High $512.86 | Professional | None | $158.49 | $331.13 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $165.96 Typical High $524.81 | Facility | None | $107.15 | $165.96 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $426.58 | Professional | None | $165.96 | $204.17 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $131.83 Typical High $269.15 | Facility | None | $91.20 | $131.83 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $288.40 | Professional | None | $199.53 | $234.42 | $288.40 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $407.38 | Professional | None | $141.25 | $199.53 | $407.38 |
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 $69.18 Median $85.11 Typical High $93.33 | Professional | 52 · Reduced service | $69.18 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $33.88 Typical High $37.15 | Professional | 53 · Discontinued | $27.54 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $128.82 Typical High $141.25 | Professional | 54 · Surgery only | $102.33 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $25.70 Typical High $28.18 | Professional | 55 · Aftercare only | $20.42 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $16.98 Typical High $18.62 | Professional | 56 · Pre-op care only | $13.80 | $16.98 | $18.62 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $42.66 Median $66.07 Typical High $104.71 | Facility | 51 · Multiple procedures | $42.66 | $66.07 | $104.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $104.71 Median $117.49 Typical High $245.47 | Professional | 51 · Multiple procedures | $104.71 | $117.49 | $245.47 |
Where North Carolina sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 16th of 51
$251
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.