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 $48.98 Median $75.86 Typical High $5,248.07 | Facility | None | $48.98 | $75.86 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $131.83 | Professional | None | $48.98 | $75.86 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $72.44 Typical High $154.88 | Professional | None | $54.95 | $72.44 | $154.88 |
BCBS North Carolina Setting Facility Modifier None Typical Low $48.98 Median $69.18 Typical High $93.33 | Facility | None | $48.98 | $69.18 | $93.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $85.11 Median $190.55 Typical High $346.74 | Professional | None | $85.11 | $190.55 | $346.74 |
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 $67.61 Median $112.20 Typical High $208.93 | Professional | None | $67.61 | $112.20 | $208.93 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $91.20 | Facility | None | $43.65 | $69.18 | $91.20 |
Medcost Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $177.83 | Professional | None | $81.28 | $131.83 | $177.83 |
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 $50.12 Median $95.50 Typical High $190.55 | Professional | None | $50.12 | $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 $24.55 Median $33.88 Typical High $38.90 | Professional | 52 · Reduced service | $24.55 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $13.80 Typical High $15.85 | Professional | 53 · Discontinued | $10.00 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $51.29 Typical High $58.88 | Professional | 54 · Surgery only | $37.15 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $10.23 Typical High $11.75 | Professional | 55 · Aftercare only | $7.41 | $10.23 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.92 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.90 | $6.92 | $7.76 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $120.23 Median $245.47 Typical High $331.13 | Professional | 50 · Both sides | $120.23 | $245.47 | $331.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $40.74 Median $81.28 Typical High $109.65 | Professional | 51 · Multiple procedures | $40.74 | $81.28 | $109.65 |
Where North Carolina sits
The same service costs 3.2 times more in Wisconsin 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· 6th of 51
$138
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.