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 $64.57 Median $102.33 Typical High $5,248.07 | Facility | None | $64.57 | $102.33 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $141.25 | Professional | None | $64.57 | $100.00 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
BCBS North Carolina Setting Facility Modifier None Typical Low $40.74 Median $63.10 Typical High $162.18 | Facility | None | $40.74 | $63.10 | $162.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $251.19 | Professional | None | $95.50 | $154.88 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $109.65 Typical High $524.81 | Facility | None | $69.18 | $109.65 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $208.93 | Professional | None | $79.43 | $104.71 | $208.93 |
Medcost Setting Facility Modifier None Typical Low $48.98 Median $72.44 Typical High $125.89 | Facility | None | $48.98 | $72.44 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $169.82 | Professional | None | $100.00 | $112.20 | $169.82 |
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 $66.07 Median $102.33 Typical High $213.80 | Professional | None | $66.07 | $102.33 | $213.80 |
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 $32.36 Median $41.69 Typical High $51.29 | Professional | 52 · Reduced service | $32.36 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.60 Typical High $20.42 | Professional | 53 · Discontinued | $12.88 | $16.60 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $63.10 Typical High $75.86 | Professional | 54 · Surgery only | $47.86 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $12.59 Typical High $15.14 | Professional | 55 · Aftercare only | $9.77 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.32 Typical High $10.23 | Professional | 56 · Pre-op care only | $6.46 | $8.32 | $10.23 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $22.91 Median $36.31 Typical High $60.26 | Facility | 51 · Multiple procedures | $22.91 | $36.31 | $60.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $66.07 Typical High $134.90 | Professional | 51 · Multiple procedures | $48.98 | $66.07 | $134.90 |
Where North Carolina sits
The same service costs 3.6 times more in Wisconsin 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· 11th of 51
$138
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.