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 $50.12 Median $109.65 Typical High $1,584.89 | Facility | None | $50.12 | $109.65 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $91.20 Typical High $151.36 | Professional | None | $50.12 | $91.20 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $91.20 Typical High $158.49 | Professional | None | $45.71 | $91.20 | $158.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $208.93 | Professional | None | $79.43 | $128.82 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $186.21 | Facility | None | $50.12 | $50.12 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $104.71 Typical High $186.21 | Professional | None | $64.57 | $104.71 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $60.26 Median $331.13 Typical High $524.81 | Facility | None | $60.26 | $331.13 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $177.83 | Professional | None | $93.33 | $112.20 | $177.83 |
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 $52.48 Median $89.13 Typical High $169.82 | Professional | None | $52.48 | $89.13 | $169.82 |
6 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 $25.12 Median $38.90 Typical High $54.95 | Professional | 52 · Reduced service | $25.12 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $15.49 Typical High $21.88 | Professional | 53 · Discontinued | $10.00 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $58.88 Typical High $83.18 | Professional | 54 · Surgery only | $37.15 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $11.75 Typical High $16.60 | Professional | 55 · Aftercare only | $7.59 | $11.75 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $7.76 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.01 | $7.76 | $10.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $46.77 Median $57.54 Typical High $128.82 | Professional | 51 · Multiple procedures | $46.77 | $57.54 | $128.82 |
Where North Carolina sits
The same service costs 3.2 times more in Alaska than in New York. 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
$120
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.