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 $117.49 Median $263.03 Typical High $7,413.10 | Facility | None | $117.49 | $263.03 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $263.03 Typical High $309.03 | Professional | None | $117.49 | $263.03 | $309.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $676.08 | Professional | None | $257.04 | $398.11 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $295.12 Typical High $588.84 | Professional | None | $158.49 | $295.12 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $281.84 | Facility | None | $117.49 | $117.49 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $562.34 | Professional | None | $309.03 | $338.84 | $562.34 |
Oscar Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $2,570.40 Typical High $4,365.16 | Facility | None | $1,778.28 | $2,570.40 | $4,365.16 |
United Setting Professional Modifier None Typical Low $123.03 Median $257.04 Typical High $501.19 | Professional | None | $123.03 | $257.04 | $501.19 |
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 $58.88 Median $104.71 Typical High $138.04 | Professional | 52 · Reduced service | $58.88 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $42.66 Typical High $54.95 | Professional | 53 · Discontinued | $23.44 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $158.49 Typical High $204.17 | Professional | 54 · Surgery only | $87.10 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $31.62 Typical High $40.74 | Professional | 55 · Aftercare only | $17.78 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $21.38 Typical High $27.54 | Professional | 56 · Pre-op care only | $11.75 | $21.38 | $27.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $169.82 Typical High $363.08 | Professional | 51 · Multiple procedures | $169.82 | $169.82 | $363.08 |
Where North Carolina sits
The same service costs 3.4 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
$398
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.