How much rates vary
Facilitymedian $141 · 10th to 90th $71 to $871Professionalmedian $132 · 10th to 90th $71 to $288
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 $48.98 Median $109.65 Typical High $1,584.89 | Facility | None | $48.98 | $109.65 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $109.65 Typical High $173.78 | Professional | None | $48.98 | $109.65 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $87.10 | Professional | None | $54.95 | $54.95 | $87.10 |
BCBS North Carolina Setting Facility Modifier None Typical Low $72.44 Median $112.20 Typical High $288.40 | Facility | None | $72.44 | $112.20 | $288.40 |
BCBS North Carolina Setting Professional Modifier None Typical Low $87.10 Median $151.36 Typical High $338.84 | Professional | None | $87.10 | $151.36 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $169.82 Typical High $524.81 | Facility | None | $107.15 | $169.82 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $125.89 Typical High $223.87 | Professional | None | $69.18 | $125.89 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $269.15 | Professional | None | $181.97 | $181.97 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $141.25 Typical High $245.47 | Facility | None | $91.20 | $141.25 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $213.80 | Professional | None | $104.71 | $147.91 | $213.80 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $47.86 Median $102.33 Typical High $218.78 | Professional | None | $47.86 | $102.33 | $218.78 |
9 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 $24.55 Median $48.98 Typical High $54.95 | Professional | 52 · Reduced service | $24.55 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $19.50 Typical High $21.88 | Professional | 53 · Discontinued | $9.77 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $74.13 Typical High $83.18 | Professional | 54 · Surgery only | $36.31 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $14.79 Typical High $16.60 | Professional | 55 · Aftercare only | $7.41 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $9.77 Typical High $10.96 | Professional | 56 · Pre-op care only | $4.90 | $9.77 | $10.96 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $134.90 Median $208.93 Typical High $363.08 | Facility | 50 · Both sides | $134.90 | $208.93 | $363.08 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $44.67 Median $70.79 Typical High $120.23 | Facility | 51 · Multiple procedures | $44.67 | $70.79 | $120.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $154.88 Median $257.04 Typical High $389.05 | Professional | 50 · Both sides | $154.88 | $257.04 | $389.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $52.48 Median $87.10 Typical High $128.82 | Professional | 51 · Multiple procedures | $52.48 | $87.10 | $128.82 |
Where North Carolina sits
The same service costs 3.4 times more in Alaska than in Kentucky. 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· 11th of 51
$132
AK $234KY $69.18
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.