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 $44.67 Median $72.44 Typical High $5,248.07 | Facility | None | $44.67 | $72.44 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $72.44 Typical High $107.15 | Professional | None | $44.67 | $72.44 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $123.03 | Professional | None | $93.33 | $109.65 | $123.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $41.69 Median $64.57 Typical High $165.96 | Facility | None | $41.69 | $64.57 | $165.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $70.79 Median $141.25 Typical High $208.93 | Professional | None | $70.79 | $141.25 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $60.26 Typical High $114.82 | Facility | None | $42.66 | $60.26 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $147.91 | Professional | None | $57.54 | $85.11 | $147.91 |
Medcost Setting Facility Modifier None Typical Low $47.86 Median $74.13 Typical High $95.50 | Facility | None | $47.86 | $74.13 | $95.50 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $95.50 Typical High $120.23 | Professional | None | $70.79 | $95.50 | $120.23 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $46.77 Median $75.86 Typical High $151.36 | Professional | None | $46.77 | $75.86 | $151.36 |
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 $22.39 Median $29.51 Typical High $36.31 | Professional | 52 · Reduced service | $22.39 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $11.75 Typical High $14.45 | Professional | 53 · Discontinued | $8.91 | $11.75 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $44.67 Typical High $54.95 | Professional | 54 · Surgery only | $33.88 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $8.91 Typical High $10.96 | Professional | 55 · Aftercare only | $6.76 | $8.91 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.89 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.47 | $5.89 | $7.24 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $23.44 Median $37.15 Typical High $38.90 | Facility | 51 · Multiple procedures | $23.44 | $37.15 | $38.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $35.48 Median $57.54 Typical High $95.50 | Professional | 51 · Multiple procedures | $35.48 | $57.54 | $95.50 |
Where North Carolina sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 9th of 51
$105
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.