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 $33.11 Median $39.81 Typical High $1,288.25 | Facility | None | $33.11 | $39.81 | $1,288.25 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $39.81 Typical High $51.29 | Professional | None | $33.11 | $39.81 | $51.29 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $22.91 Median $32.36 Typical High $43.65 | Facility | None | $22.91 | $32.36 | $43.65 |
BCBS North Carolina Setting Professional Modifier None Typical Low $33.88 Median $87.10 Typical High $131.83 | Professional | None | $33.88 | $87.10 | $131.83 |
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 $28.18 Median $37.15 Typical High $74.13 | Professional | None | $28.18 | $37.15 | $74.13 |
Medcost Setting Facility Modifier None Typical Low $25.70 Median $39.81 Typical High $52.48 | Facility | None | $25.70 | $39.81 | $52.48 |
Medcost Setting Professional Modifier None Typical Low $38.90 Median $61.66 Typical High $61.66 | Professional | None | $38.90 | $61.66 | $61.66 |
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 $32.36 Median $40.74 Typical High $77.62 | Professional | None | $32.36 | $40.74 | $77.62 |
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 $16.60 Median $19.95 Typical High $22.91 | Professional | 52 · Reduced service | $16.60 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $8.13 Typical High $9.12 | Professional | 53 · Discontinued | $6.61 | $8.13 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $30.20 Typical High $34.67 | Professional | 54 · Surgery only | $24.55 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $6.03 Typical High $6.92 | Professional | 55 · Aftercare only | $4.90 | $6.03 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $4.07 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.31 | $4.07 | $4.57 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $58.88 Median $91.20 Typical High $114.82 | Professional | 50 · Both sides | $58.88 | $91.20 | $114.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.50 Median $30.20 Typical High $38.02 | Professional | 51 · Multiple procedures | $19.50 | $30.20 | $38.02 |
Where North Carolina sits
The same service costs 3.8 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· 24th of 51
$51.29
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.