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 $158.49 Median $354.81 Typical High $7,413.10 | Facility | None | $158.49 | $354.81 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $346.74 Typical High $426.58 | Professional | None | $158.49 | $346.74 | $426.58 |
BCBS North Carolina Setting Professional Modifier None Typical Low $309.03 Median $478.63 Typical High $912.01 | Professional | None | $309.03 | $478.63 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $389.05 Typical High $776.25 | Professional | None | $199.53 | $389.05 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Medcost Setting Facility Modifier None Typical Low $158.49 Median $162.18 Typical High $416.87 | Facility | None | $158.49 | $162.18 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $741.31 | Professional | None | $323.59 | $407.38 | $741.31 |
Oscar Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
United Setting Facility Modifier None Typical Low $512.86 Median $891.25 Typical High $2,089.30 | Facility | None | $512.86 | $891.25 | $2,089.30 |
United Setting Professional Modifier None Typical Low $165.96 Median $346.74 Typical High $676.08 | Professional | None | $165.96 | $346.74 | $676.08 |
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 $79.43 Median $138.04 Typical High $181.97 | Professional | 52 · Reduced service | $79.43 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $54.95 Typical High $72.44 | Professional | 53 · Discontinued | $31.62 | $54.95 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $208.93 Typical High $275.42 | Professional | 54 · Surgery only | $117.49 | $208.93 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $41.69 Typical High $54.95 | Professional | 55 · Aftercare only | $23.44 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $27.54 Typical High $36.31 | Professional | 56 · Pre-op care only | $15.85 | $27.54 | $36.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $199.53 Typical High $489.78 | Professional | 51 · Multiple procedures | $158.49 | $199.53 | $489.78 |
Where North Carolina sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 10th of 51
$447
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.