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 $602.56 Median $1,584.89 Typical High $11,748.98 | Facility | None | $602.56 | $1,584.89 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $954.99 | Professional | None | $602.56 | $602.56 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
BCBS North Carolina Setting Facility Modifier None Typical Low $8,912.51 Median $14,125.38 Typical High $45,708.82 | Facility | None | $8,912.51 | $14,125.38 | $45,708.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $831.76 Median $1,445.44 Typical High $2,041.74 | Professional | None | $831.76 | $1,445.44 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $14,791.08 Typical High $24,547.09 | Facility | None | $602.56 | $14,791.08 | $24,547.09 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,659.59 | Professional | None | $758.58 | $870.96 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $12,022.64 Typical High $29,512.09 | Facility | None | $630.96 | $12,022.64 | $29,512.09 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,047.13 | Professional | None | $602.56 | $851.14 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,365.16 | $17,782.79 |
United Setting Professional Modifier None Typical Low $616.60 Median $891.25 Typical High $1,584.89 | Professional | None | $616.60 | $891.25 | $1,584.89 |
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 $302.00 Median $302.00 Typical High $338.84 | Professional | 52 · Reduced service | $302.00 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $134.90 | Professional | 53 · Discontinued | $120.23 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $512.86 | Professional | 54 · Surgery only | $446.68 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $102.33 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $67.61 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $67.61 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,288.25 Typical High $2,454.71 | Professional | 50 · Both sides | $1,174.90 | $1,288.25 | $2,454.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $389.05 Median $426.58 Typical High $812.83 | Professional | 51 · Multiple procedures | $389.05 | $426.58 | $812.83 |
Where North Carolina sits
The same service costs 11.7 times more in Oklahoma 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· 16th of 51
$1,175
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.