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 $87.10 Median $128.82 Typical High $7,413.10 | Facility | None | $87.10 | $128.82 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $194.98 | Professional | None | $87.10 | $128.82 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $52.48 Median $83.18 Typical High $208.93 | Facility | None | $52.48 | $83.18 | $208.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $302.00 | Professional | None | $128.82 | $194.98 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $141.25 Typical High $524.81 | Facility | None | $89.13 | $141.25 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $275.42 | Professional | None | $107.15 | $134.90 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $64.57 Median $93.33 Typical High $154.88 | Facility | None | $64.57 | $93.33 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $213.80 | Professional | None | $125.89 | $147.91 | $213.80 |
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 $91.20 Median $138.04 Typical High $288.40 | Professional | None | $91.20 | $138.04 | $288.40 |
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 $43.65 Median $56.23 Typical High $64.57 | Professional | 52 · Reduced service | $43.65 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $22.91 Typical High $25.70 | Professional | 53 · Discontinued | $17.38 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $85.11 Typical High $97.72 | Professional | 54 · Surgery only | $66.07 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $16.98 Typical High $19.50 | Professional | 55 · Aftercare only | $13.18 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.22 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.71 | $11.22 | $12.88 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $30.20 Median $46.77 Typical High $75.86 | Facility | 51 · Multiple procedures | $30.20 | $46.77 | $75.86 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $93.33 Typical High $177.83 | Professional | 51 · Multiple procedures | $63.10 | $93.33 | $177.83 |
Where North Carolina sits
The same service costs 3.3 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· 13th of 51
$178
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.