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 $114.82 Median $251.19 Typical High $5,248.07 | Facility | None | $114.82 | $251.19 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $251.19 Typical High $371.54 | Professional | None | $114.82 | $251.19 | $371.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $645.65 | Professional | None | $245.47 | $389.05 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $562.34 | Professional | None | $154.88 | $288.40 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $275.42 | Facility | None | $114.82 | $114.82 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $537.03 | Professional | None | $295.12 | $323.59 | $537.03 |
Oscar Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $120.23 Median $251.19 Typical High $489.78 | Professional | None | $120.23 | $251.19 | $489.78 |
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 $57.54 Median $102.33 Typical High $131.83 | Professional | 52 · Reduced service | $57.54 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $40.74 Typical High $53.70 | Professional | 53 · Discontinued | $22.91 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $151.36 Typical High $199.53 | Professional | 54 · Surgery only | $87.10 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $30.20 Typical High $39.81 | Professional | 55 · Aftercare only | $17.38 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $20.42 Typical High $26.92 | Professional | 56 · Pre-op care only | $11.48 | $20.42 | $26.92 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $162.18 Median $162.18 Typical High $354.81 | Professional | 51 · Multiple procedures | $162.18 | $162.18 | $354.81 |
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
$389
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.