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 $144.54 Median $323.59 Typical High $7,413.10 | Facility | None | $144.54 | $323.59 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $281.84 Typical High $363.08 | Professional | None | $144.54 | $281.84 | $363.08 |
BCBS North Carolina Setting Professional Modifier None Typical Low $295.12 Median $562.34 Typical High $851.14 | Professional | None | $295.12 | $562.34 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $371.54 Typical High $724.44 | Professional | None | $190.55 | $371.54 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $151.36 Typical High $380.19 | Facility | None | $144.54 | $151.36 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $707.95 | Professional | None | $302.00 | $478.63 | $707.95 |
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 $158.49 Median $323.59 Typical High $645.65 | Professional | None | $158.49 | $323.59 | $645.65 |
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 $72.44 Median $134.90 Typical High $162.18 | Professional | 52 · Reduced service | $72.44 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $53.70 Typical High $64.57 | Professional | 53 · Discontinued | $28.84 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $199.53 Typical High $245.47 | Professional | 54 · Surgery only | $109.65 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $39.81 Typical High $48.98 | Professional | 55 · Aftercare only | $21.88 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $26.92 Typical High $32.36 | Professional | 56 · Pre-op care only | $14.45 | $26.92 | $32.36 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $239.88 Typical High $457.09 | Professional | 51 · Multiple procedures | $158.49 | $239.88 | $457.09 |
Where North Carolina sits
The same service costs 3.5 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· 3rd of 51
$537
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.