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 $1,000.00 Median $1,000.00 Typical High $7,943.28 | Facility | None | $1,000.00 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,258.93 | Professional | None | $1,000.00 | $1,000.00 | $1,258.93 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,949.84 Median $2,884.03 Typical High $4,073.80 | Facility | None | $1,949.84 | $2,884.03 | $4,073.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,949.84 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,187.76 Typical High $3,548.13 | Facility | None | $602.56 | $2,187.76 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $2,691.53 | Professional | None | $831.76 | $1,258.93 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,949.84 Typical High $4,073.80 | Facility | None | $1,122.02 | $1,949.84 | $4,073.80 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,659.59 | Professional | None | $891.25 | $1,148.15 | $1,659.59 |
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 $870.96 Median $1,148.15 Typical High $2,454.71 | Professional | None | $870.96 | $1,148.15 | $2,454.71 |
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 $501.19 Median $501.19 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $501.19 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $870.96 | Professional | 54 · Surgery only | $758.58 | $758.58 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $812.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $575.44 Typical High $1,445.44 | Professional | 51 · Multiple procedures | $446.68 | $575.44 | $1,445.44 |
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· 13th of 51
$1,778
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.