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 $1,288.25 Median $1,584.89 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,584.89 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,584.89 | $1,862.09 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $2,818.38 Typical High $3,890.45 | Facility | None | $1,905.46 | $2,818.38 | $3,890.45 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,047.13 Median $2,754.23 Typical High $4,265.80 | Professional | None | $1,047.13 | $2,754.23 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,584.89 | $3,235.94 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $4,265.80 | Professional | None | $1,584.89 | $2,041.74 | $4,265.80 |
Medcost Setting Facility Modifier None Typical Low $1,513.56 Median $2,398.83 Typical High $5,128.61 | Facility | None | $1,513.56 | $2,398.83 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,737.80 | $1,905.46 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $3,890.45 | Professional | None | $1,513.56 | $2,041.74 | $3,890.45 |
8 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 $794.33 Median $794.33 Typical High $933.25 | Professional | 52 · Reduced service | $794.33 | $794.33 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | 53 · Discontinued | $316.23 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $275.42 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $186.21 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,288.25 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $758.58 Median $1,174.90 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $758.58 | $1,174.90 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $954.99 Typical High $2,238.72 | Professional | 51 · Multiple procedures | $870.96 | $954.99 | $2,238.72 |
Where North Carolina sits
The same service costs 6.6 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· 24th of 51
$2,344
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.