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 $173.78 Median $1,000.00 Typical High $7,943.28 | Facility | None | $173.78 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $218.78 | Professional | None | $173.78 | $173.78 | $218.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $354.81 Median $537.03 Typical High $724.44 | Facility | None | $354.81 | $537.03 | $724.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $549.54 | Professional | None | $229.09 | $389.05 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $281.84 Typical High $436.52 | Facility | None | $194.98 | $281.84 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $371.54 | Professional | None | $208.93 | $245.47 | $371.54 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $354.81 Typical High $478.63 | Facility | None | $199.53 | $354.81 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $281.84 | Professional | None | $204.17 | $229.09 | $281.84 |
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 $173.78 Median $251.19 Typical High $426.58 | Professional | None | $173.78 | $251.19 | $426.58 |
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 $87.10 Median $87.10 Typical High $100.00 | Professional | 52 · Reduced service | $87.10 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $39.81 | Professional | 53 · Discontinued | $34.67 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $151.36 | Professional | 54 · Surgery only | $128.82 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $19.95 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $19.95 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $112.20 Median $186.21 Typical High $239.88 | Facility | 51 · Multiple procedures | $112.20 | $186.21 | $239.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $114.82 Typical High $251.19 | Professional | 51 · Multiple procedures | $102.33 | $114.82 | $251.19 |
Where North Carolina sits
The same service costs 3.2 times more in Alaska than in Texas. 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
$331
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.