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 $46.77 Median $60.26 Typical High $5,248.07 | Facility | None | $46.77 | $60.26 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $60.26 Typical High $77.62 | Professional | None | $46.77 | $60.26 | $77.62 |
BCBS North Carolina Setting Facility Modifier None Typical Low $30.90 Median $47.86 Typical High $123.03 | Facility | None | $30.90 | $47.86 | $123.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $173.78 | Professional | None | $52.48 | $69.18 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $54.95 Typical High $104.71 | Facility | None | $38.90 | $54.95 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $57.54 Typical High $117.49 | Professional | None | $44.67 | $57.54 | $117.49 |
Medcost Setting Facility Modifier None Typical Low $39.81 Median $57.54 Typical High $95.50 | Facility | None | $39.81 | $57.54 | $95.50 |
Medcost Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $380.19 | Professional | None | $77.62 | $87.10 | $380.19 |
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 $47.86 Median $64.57 Typical High $117.49 | Professional | None | $47.86 | $64.57 | $117.49 |
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 $22.91 Median $30.20 Typical High $33.11 | Professional | 52 · Reduced service | $22.91 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $12.02 Typical High $13.49 | Professional | 53 · Discontinued | $9.33 | $12.02 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $44.67 Typical High $50.12 | Professional | 54 · Surgery only | $34.67 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $8.91 Typical High $10.00 | Professional | 55 · Aftercare only | $6.92 | $8.91 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.03 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.68 | $6.03 | $6.76 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $54.95 Median $87.10 Typical High $125.89 | Facility | 50 · Both sides | $54.95 | $87.10 | $125.89 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $18.62 Median $28.84 Typical High $42.66 | Facility | 51 · Multiple procedures | $18.62 | $28.84 | $42.66 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $223.87 Typical High $575.44 | Professional | 50 · Both sides | $117.49 | $223.87 | $575.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $38.90 Median $74.13 Typical High $190.55 | Professional | 51 · Multiple procedures | $38.90 | $74.13 | $190.55 |
Where North Carolina sits
The same service costs 3.7 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· 35th of 51
$69.18
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.