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 $42.66 Median $79.43 Typical High $7,413.10 | Facility | None | $42.66 | $79.43 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $79.43 Typical High $134.90 | Professional | None | $42.66 | $79.43 | $134.90 |
BCBS North Carolina Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $158.49 | Facility | None | $79.43 | $117.49 | $158.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $100.00 Median $177.83 Typical High $371.54 | Professional | None | $100.00 | $177.83 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $87.10 Typical High $524.81 | Facility | None | $54.95 | $87.10 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $138.04 Typical High $234.42 | Professional | None | $81.28 | $138.04 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $245.47 | Professional | None | $190.55 | $245.47 | $245.47 |
Medcost Setting Facility Modifier None Typical Low $64.57 Median $125.89 Typical High $229.09 | Facility | None | $64.57 | $125.89 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $173.78 Typical High $239.88 | Professional | None | $83.18 | $173.78 | $239.88 |
United Setting Facility Modifier None Typical Low $295.12 Median $524.81 Typical High $2,818.38 | Facility | None | $295.12 | $524.81 | $2,818.38 |
United Setting Professional Modifier None Typical Low $42.66 Median $93.33 Typical High $218.78 | Professional | None | $42.66 | $93.33 | $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 $20.89 Median $39.81 Typical High $45.71 | Professional | 52 · Reduced service | $20.89 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $15.85 Typical High $18.62 | Professional | 53 · Discontinued | $8.51 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $58.88 Typical High $69.18 | Professional | 54 · Surgery only | $31.62 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $11.75 Typical High $13.80 | Professional | 55 · Aftercare only | $6.31 | $11.75 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $7.94 Typical High $9.12 | Professional | 56 · Pre-op care only | $4.27 | $7.94 | $9.12 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $117.49 Median $208.93 Typical High $346.74 | Facility | 50 · Both sides | $117.49 | $208.93 | $346.74 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $39.81 Median $69.18 Typical High $114.82 | Facility | 51 · Multiple procedures | $39.81 | $69.18 | $114.82 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $263.03 Typical High $354.81 | Professional | 50 · Both sides | $125.89 | $263.03 | $354.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $41.69 Median $87.10 Typical High $120.23 | Professional | 51 · Multiple procedures | $41.69 | $87.10 | $120.23 |
Where North Carolina sits
The same service costs 3.2 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· 2nd of 51
$178
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.