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 $109.65 Median $1,000.00 Typical High $7,943.28 | Facility | None | $109.65 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | None | $109.65 | $109.65 | $131.83 |
BCBS Setting Facility Modifier None Typical Low $407.38 Median $630.96 Typical High $1,621.81 | Facility | None | $407.38 | $630.96 | $1,621.81 |
BCBS Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $302.00 | Professional | None | $144.54 | $234.42 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $645.65 Typical High $1,000.00 | Facility | None | $380.19 | $645.65 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $295.12 | Professional | None | $114.82 | $147.91 | $295.12 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $537.03 Typical High $575.44 | Facility | None | $186.21 | $537.03 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $190.55 | Professional | None | $123.03 | $138.04 | $190.55 |
United Setting Facility Modifier None Typical Low $295.12 Median $524.81 Typical High $2,818.38 | Facility | None | $295.12 | $524.81 | $2,818.38 |
United Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $269.15 | Professional | None | $104.71 | $147.91 | $269.15 |
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 $54.95 Median $54.95 Typical High $63.10 | Professional | 52 · Reduced service | $54.95 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $25.12 | Professional | 53 · Discontinued | $21.88 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $93.33 | Professional | 54 · Surgery only | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $19.05 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $12.59 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $173.78 Median $269.15 Typical High $416.87 | Facility | 51 · Multiple procedures | $173.78 | $269.15 | $416.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $69.18 Typical High $154.88 | Professional | 51 · Multiple procedures | $63.10 | $69.18 | $154.88 |
Where North Carolina sits
The same service costs 4.4 times more in Alaska 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· 15th of 51
$229
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.