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 $60.26 Median $141.25 Typical High $5,248.07 | Facility | None | $60.26 | $141.25 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $120.23 Typical High $158.49 | Professional | None | $60.26 | $120.23 | $158.49 |
BCBS North Carolina Setting Facility Modifier None Typical Low $109.65 Median $173.78 Typical High $478.63 | Facility | None | $109.65 | $173.78 | $478.63 |
BCBS North Carolina Setting Professional Modifier None Typical Low $93.33 Median $208.93 Typical High $389.05 | Professional | None | $93.33 | $208.93 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $208.93 Typical High $645.65 | Facility | None | $131.83 | $208.93 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $138.04 Typical High $288.40 | Professional | None | $72.44 | $138.04 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $199.53 Typical High $288.40 | Facility | None | $128.82 | $199.53 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $234.42 | Professional | None | $112.20 | $165.96 | $234.42 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $61.66 Median $134.90 Typical High $275.42 | Professional | None | $61.66 | $134.90 | $275.42 |
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 $30.20 Median $50.12 Typical High $70.79 | Professional | 52 · Reduced service | $30.20 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $20.42 Typical High $28.84 | Professional | 53 · Discontinued | $12.02 | $20.42 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $75.86 Typical High $107.15 | Professional | 54 · Surgery only | $45.71 | $75.86 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $15.14 Typical High $21.38 | Professional | 55 · Aftercare only | $9.12 | $15.14 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $10.00 Typical High $14.13 | Professional | 56 · Pre-op care only | $6.03 | $10.00 | $14.13 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $204.17 Median $295.12 Typical High $436.52 | Facility | 50 · Both sides | $204.17 | $295.12 | $436.52 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $67.61 Median $100.00 Typical High $144.54 | Facility | 51 · Multiple procedures | $67.61 | $100.00 | $144.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $251.19 Typical High $588.84 | Professional | 50 · Both sides | $169.82 | $251.19 | $588.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $56.23 Median $83.18 Typical High $194.98 | Professional | 51 · Multiple procedures | $56.23 | $83.18 | $194.98 |
Where North Carolina sits
The same service costs 5.9 times more in Oklahoma 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
$166
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.