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 $74.13 Median $93.33 Typical High $5,248.07 | Facility | None | $74.13 | $93.33 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $147.91 | Professional | None | $74.13 | $93.33 | $147.91 |
BCBS North Carolina Setting Facility Modifier None Typical Low $57.54 Median $93.33 Typical High $251.19 | Facility | None | $57.54 | $93.33 | $251.19 |
BCBS North Carolina Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $263.03 | Professional | None | $102.33 | $128.82 | $263.03 |
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 $107.15 Typical High $186.21 | Professional | None | $85.11 | $107.15 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $45.71 Median $70.79 Typical High $338.84 | Facility | None | $45.71 | $70.79 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $151.36 | Professional | None | $67.61 | $89.13 | $151.36 |
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 $75.86 Median $109.65 Typical High $190.55 | Professional | None | $75.86 | $109.65 | $190.55 |
10 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 $37.15 Median $46.77 Typical High $52.48 | Professional | 52 · Reduced service | $37.15 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $18.62 Typical High $20.89 | Professional | 53 · Discontinued | $14.79 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $69.18 Typical High $79.43 | Professional | 54 · Surgery only | $56.23 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.80 Typical High $15.85 | Professional | 55 · Aftercare only | $11.22 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.33 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.41 | $9.33 | $10.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $52.48 Median $64.57 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $52.48 | $64.57 | $74.13 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $67.61 Median $107.15 Typical High $107.15 | Facility | 50 · Both sides | $67.61 | $107.15 | $107.15 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $22.91 Median $35.48 Typical High $35.48 | Facility | 51 · Multiple procedures | $22.91 | $35.48 | $35.48 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $134.90 Typical High $331.13 | Professional | 50 · Both sides | $102.33 | $134.90 | $331.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.88 Median $44.67 Typical High $112.20 | Professional | 51 · Multiple procedures | $33.88 | $44.67 | $112.20 |
Where North Carolina sits
The same service costs 4.2 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· 20th of 51
$126
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.