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 $104.71 Median $1,000.00 Typical High $7,943.28 | Facility | None | $104.71 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $123.03 | Professional | None | $104.71 | $104.71 | $123.03 |
BCBS North Carolina 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 North Carolina Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $288.40 | Professional | None | $141.25 | $229.09 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $630.96 Typical High $933.25 | Facility | None | $380.19 | $630.96 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $257.04 | Professional | None | $117.49 | $141.25 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $537.03 Typical High $575.44 | Facility | None | $190.55 | $537.03 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $177.83 | Professional | None | $117.49 | $147.91 | $177.83 |
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 $141.25 Typical High $257.04 | Professional | None | $104.71 | $141.25 | $257.04 |
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 $51.29 Median $51.29 Typical High $61.66 | Professional | 52 · Reduced service | $51.29 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $24.55 | Professional | 53 · Discontinued | $20.89 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | 54 · Surgery only | $77.62 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $18.20 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $12.30 |
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 $74.13 Typical High $147.91 | Professional | 51 · Multiple procedures | $63.10 | $74.13 | $147.91 |
Where North Carolina sits
The same service costs 4.4 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· 15th of 51
$219
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.