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 $173.78 Typical High $7,413.10 | Facility | None | $114.82 | $173.78 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $263.03 | Professional | None | $114.82 | $173.78 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $208.93 | Professional | None | $162.18 | $162.18 | $208.93 |
BCBS North Carolina Setting Facility Modifier None Typical Low $81.28 Median $120.23 Typical High $162.18 | Facility | None | $81.28 | $120.23 | $162.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $181.97 Median $302.00 Typical High $426.58 | Professional | None | $181.97 | $302.00 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $204.17 Typical High $524.81 | Facility | None | $120.23 | $204.17 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $354.81 | Professional | None | $141.25 | $190.55 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $151.36 Typical High $251.19 | Facility | None | $91.20 | $151.36 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $288.40 | Professional | None | $199.53 | $213.80 | $288.40 |
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 $109.65 Median $169.82 Typical High $331.13 | Professional | None | $109.65 | $169.82 | $331.13 |
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 $79.43 Typical High $87.10 | Professional | 52 · Reduced service | $57.54 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $31.62 Typical High $35.48 | Professional | 53 · Discontinued | $22.91 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $117.49 Typical High $131.83 | Professional | 54 · Surgery only | $85.11 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $23.44 Typical High $26.30 | Professional | 55 · Aftercare only | $16.98 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $15.85 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.48 | $15.85 | $17.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $107.15 Typical High $223.87 | Professional | 51 · Multiple procedures | $107.15 | $107.15 | $223.87 |
Where North Carolina sits
The same service costs 3.3 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· 6th of 51
$275
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.