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 $426.58 Median $2,137.96 Typical High $8,511.38 | Facility | None | $426.58 | $2,137.96 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $2,089.30 Typical High $2,570.40 | Professional | None | $426.58 | $2,089.30 | $2,570.40 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,884.03 Typical High $4,570.88 | Facility | None | $1,778.28 | $2,884.03 | $4,570.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $457.09 Median $1,995.26 Typical High $5,754.40 | Professional | None | $457.09 | $1,995.26 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,128.61 Typical High $8,511.38 | Facility | None | $602.56 | $5,128.61 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $1,995.26 Typical High $3,311.31 | Professional | None | $389.05 | $1,995.26 | $3,311.31 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $2,570.40 Typical High $4,786.30 | Facility | None | $676.08 | $2,570.40 | $4,786.30 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $2,818.38 Typical High $2,818.38 | Professional | None | $1,995.26 | $2,818.38 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $380.19 Median $1,479.11 Typical High $3,235.94 | Professional | None | $380.19 | $1,479.11 | $3,235.94 |
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 $213.80 Median $1,047.13 Typical High $1,071.52 | Professional | 52 · Reduced service | $213.80 | $1,047.13 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $416.87 Typical High $426.58 | Professional | 53 · Discontinued | $85.11 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $1,584.89 Typical High $1,659.59 | Professional | 54 · Surgery only | $316.23 | $1,584.89 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $63.10 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $208.93 Typical High $213.80 | Professional | 56 · Pre-op care only | $42.66 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $295.12 | $1,479.11 | $1,479.11 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,019.95 Median $4,168.69 Typical High $4,168.69 | Professional | 50 · Both sides | $3,019.95 | $4,168.69 | $4,168.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,000.00 Median $1,412.54 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $1,000.00 | $1,412.54 | $1,412.54 |
Where North Carolina sits
The same service costs 9.8 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· 23rd of 51
$2,089
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.