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 $208.93 Median $275.42 Typical High $7,943.28 | Facility | None | $208.93 | $275.42 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $346.74 | Professional | None | $208.93 | $275.42 | $346.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $2,290.87 | Facility | None | $1,148.15 | $1,737.80 | $2,290.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $645.65 | Professional | None | $269.15 | $436.52 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,862.09 Typical High $2,238.72 | Facility | None | $645.65 | $1,862.09 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $602.56 | Professional | None | $208.93 | $288.40 | $602.56 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $870.96 Typical High $1,548.82 | Facility | None | $331.13 | $870.96 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $446.68 | Professional | None | $281.84 | $295.12 | $446.68 |
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 $204.17 Median $295.12 Typical High $588.84 | Professional | None | $204.17 | $295.12 | $588.84 |
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 $104.71 Median $120.23 Typical High $138.04 | Professional | 52 · Reduced service | $104.71 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $47.86 Typical High $54.95 | Professional | 53 · Discontinued | $41.69 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $181.97 Typical High $204.17 | Professional | 54 · Surgery only | $158.49 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $36.31 Typical High $40.74 | Professional | 55 · Aftercare only | $31.62 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.99 Typical High $27.54 | Professional | 56 · Pre-op care only | $20.89 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $169.82 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $147.91 | $169.82 | $190.55 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $489.78 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $295.12 | $489.78 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $165.96 Typical High $354.81 | Professional | 51 · Multiple procedures | $141.25 | $165.96 | $354.81 |
Where North Carolina sits
The same service costs 4.7 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· 20th of 51
$363
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.