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 $123.03 Median $123.03 Typical High $7,943.28 | Facility | None | $123.03 | $123.03 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $144.54 | Professional | None | $123.03 | $123.03 | $144.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $338.84 | Professional | None | $162.18 | $223.87 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $2,187.76 | Facility | None | $478.63 | $645.65 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $331.13 | Professional | None | $134.90 | $169.82 | $331.13 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $147.91 Typical High $223.87 | Facility | None | $123.03 | $147.91 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $194.98 | Professional | None | $138.04 | $154.88 | $194.98 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $295.12 | Professional | None | $117.49 | $165.96 | $295.12 |
6 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 $60.26 Median $60.26 Typical High $72.44 | Professional | 52 · Reduced service | $60.26 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $28.84 | Professional | 53 · Discontinued | $24.55 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $107.15 | Professional | 54 · Surgery only | $91.20 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $21.88 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $14.45 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $77.62 Typical High $177.83 | Professional | 51 · Multiple procedures | $74.13 | $77.62 | $177.83 |
Where North Carolina sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 17th 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.