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 $1,288.25 Median $3,981.07 Typical High $8,912.51 | Facility | None | $1,288.25 | $3,981.07 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $5,370.32 | Professional | None | $3,981.07 | $3,981.07 | $5,370.32 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,290.87 Median $3,311.31 Typical High $4,570.88 | Facility | None | $2,290.87 | $3,311.31 | $4,570.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $5,248.07 Median $8,511.38 Typical High $11,481.54 | Professional | None | $5,248.07 | $8,511.38 | $11,481.54 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,454.71 Typical High $4,073.80 | Facility | None | $602.56 | $2,454.71 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $4,265.80 Median $5,888.44 Typical High $9,549.93 | Professional | None | $4,265.80 | $5,888.44 | $9,549.93 |
Medcost Setting Facility Modifier None Typical Low $2,511.89 Median $3,715.35 Typical High $5,248.07 | Facility | None | $2,511.89 | $3,715.35 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $4,365.16 Median $5,370.32 Typical High $6,760.83 | Professional | None | $4,365.16 | $5,370.32 | $6,760.83 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $3,890.45 Median $5,495.41 Typical High $10,000.00 | Professional | None | $3,890.45 | $5,495.41 | $10,000.00 |
6 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 $1,995.26 Median $1,995.26 Typical High $2,691.53 | Professional | 52 · Reduced service | $1,995.26 | $1,995.26 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $1,071.52 | Professional | 53 · Discontinued | $794.33 | $794.33 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $2,951.21 Typical High $3,981.07 | Professional | 54 · Surgery only | $2,951.21 | $2,951.21 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $588.84 Typical High $794.33 | Professional | 55 · Aftercare only | $588.84 | $588.84 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $398.11 Typical High $537.03 | Professional | 56 · Pre-op care only | $398.11 | $398.11 | $537.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2,511.89 Median $2,691.53 Typical High $5,495.41 | Professional | 51 · Multiple procedures | $2,511.89 | $2,691.53 | $5,495.41 |
Where North Carolina sits
The same service costs 4.4 times more in Alaska than in Arkansas. 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· 11th of 51
$6,166
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.