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 $45.71 Median $93.33 Typical High $5,248.07 | Facility | None | $45.71 | $93.33 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $87.10 Typical High $125.89 | Professional | None | $45.71 | $87.10 | $125.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $69.18 Median $109.65 Typical High $302.00 | Facility | None | $69.18 | $109.65 | $302.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $69.18 Median $123.03 Typical High $281.84 | Professional | None | $69.18 | $123.03 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $117.49 Typical High $524.81 | Facility | None | $75.86 | $117.49 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $109.65 Typical High $199.53 | Professional | None | $54.95 | $109.65 | $199.53 |
Medcost Setting Facility Modifier None Typical Low $79.43 Median $123.03 Typical High $181.97 | Facility | None | $79.43 | $123.03 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $102.33 Median $125.89 Typical High $158.49 | Professional | None | $102.33 | $125.89 | $158.49 |
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 $95.50 Typical High $190.55 | Professional | None | $47.86 | $95.50 | $190.55 |
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 $22.91 Median $38.90 Typical High $46.77 | Professional | 52 · Reduced service | $22.91 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $15.49 Typical High $18.62 | Professional | 53 · Discontinued | $9.12 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $58.88 Typical High $70.79 | Professional | 54 · Surgery only | $33.88 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $11.75 Typical High $14.13 | Professional | 55 · Aftercare only | $6.76 | $11.75 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $7.76 Typical High $9.33 | Professional | 56 · Pre-op care only | $4.57 | $7.76 | $9.33 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $39.81 Median $61.66 Typical High $91.20 | Facility | 51 · Multiple procedures | $39.81 | $61.66 | $91.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $51.29 Median $67.61 Typical High $134.90 | Professional | 51 · Multiple procedures | $51.29 | $67.61 | $134.90 |
Where North Carolina sits
The same service costs 3.3 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· 14th of 51
$112
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.