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 $363.08 Median $1,148.15 Typical High $7,943.28 | Facility | None | $363.08 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $602.56 | Professional | None | $363.08 | $363.08 | $602.56 |
BCBS North Carolina Setting Professional Modifier None Typical Low $154.88 Median $354.81 Typical High $1,202.26 | Professional | None | $154.88 | $354.81 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $724.44 | Professional | None | $302.00 | $354.81 | $724.44 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $436.52 Typical High $1,258.93 | Facility | None | $363.08 | $436.52 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $446.68 | Professional | None | $354.81 | $446.68 | $446.68 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $776.25 | Professional | None | $316.23 | $380.19 | $776.25 |
8 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 $181.97 Median $181.97 Typical High $234.42 | Professional | 52 · Reduced service | $181.97 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $95.50 | Professional | 53 · Discontinued | $72.44 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $354.81 | Professional | 54 · Surgery only | $275.42 | $275.42 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $46.77 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $331.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $676.08 Typical High $724.44 | Professional | 50 · Both sides | $537.03 | $676.08 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $223.87 Typical High $239.88 | Professional | 51 · Multiple procedures | $177.83 | $223.87 | $239.88 |
Where North Carolina sits
The same service costs 6.9 times more in Alaska than in Utah. 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· 42nd of 51
$372
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.