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 $100.00 Median $147.91 Typical High $7,413.10 | Facility | None | $100.00 | $147.91 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $223.87 | Professional | None | $100.00 | $147.91 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $245.47 | Professional | None | $128.82 | $141.25 | $245.47 |
BCBS North Carolina Setting Facility Modifier None Typical Low $60.26 Median $89.13 Typical High $123.03 | Facility | None | $60.26 | $89.13 | $123.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $354.81 | Professional | None | $147.91 | $229.09 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $147.91 Typical High $524.81 | Facility | None | $93.33 | $147.91 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $309.03 | Professional | None | $125.89 | $158.49 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $75.86 Median $109.65 Typical High $181.97 | Facility | None | $75.86 | $109.65 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $245.47 | Professional | None | $169.82 | $190.55 | $245.47 |
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 $102.33 Median $162.18 Typical High $323.59 | Professional | None | $102.33 | $162.18 | $323.59 |
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 $50.12 Median $63.10 Typical High $74.13 | Professional | 52 · Reduced service | $50.12 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $25.70 Typical High $30.20 | Professional | 53 · Discontinued | $19.95 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $95.50 Typical High $112.20 | Professional | 54 · Surgery only | $74.13 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $19.05 Typical High $22.39 | Professional | 55 · Aftercare only | $14.79 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.88 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.00 | $12.88 | $14.79 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $35.48 Median $54.95 Typical High $91.20 | Facility | 51 · Multiple procedures | $35.48 | $54.95 | $91.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $107.15 Typical High $204.17 | Professional | 51 · Multiple procedures | $85.11 | $107.15 | $204.17 |
Where North Carolina sits
The same service costs 3.2 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· 12th of 51
$204
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.