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 $97.72 Median $109.65 Typical High $5,248.07 | Facility | None | $97.72 | $109.65 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $177.83 | Professional | None | $97.72 | $109.65 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
BCBS North Carolina Setting Facility Modifier None Typical Low $54.95 Median $81.28 Typical High $109.65 | Facility | None | $54.95 | $81.28 | $109.65 |
BCBS North Carolina Setting Professional Modifier None Typical Low $102.33 Median $186.21 Typical High $316.23 | Professional | None | $102.33 | $186.21 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $186.21 | Facility | None | $50.12 | $50.12 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $223.87 | Professional | None | $85.11 | $109.65 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $45.71 Median $70.79 Typical High $154.88 | Facility | None | $45.71 | $70.79 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $87.10 Median $162.18 Typical High $478.63 | Professional | None | $87.10 | $162.18 | $478.63 |
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 $93.33 Median $120.23 Typical High $234.42 | Professional | None | $93.33 | $120.23 | $234.42 |
7 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 $48.98 Median $54.95 Typical High $64.57 | Professional | 52 · Reduced service | $48.98 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $22.39 Typical High $25.70 | Professional | 53 · Discontinued | $19.50 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $83.18 Typical High $95.50 | Professional | 54 · Surgery only | $72.44 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.60 Typical High $19.50 | Professional | 55 · Aftercare only | $14.45 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.96 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.77 | $10.96 | $12.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $371.54 Typical High $707.95 | Professional | 50 · Both sides | $162.18 | $371.54 | $707.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $53.70 Median $123.03 Typical High $239.88 | Professional | 51 · Multiple procedures | $53.70 | $123.03 | $239.88 |
Where North Carolina sits
The same service costs 4.5 times more in Alaska than in Florida. 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· 28th of 51
$138
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.