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 $70.79 Median $165.96 Typical High $7,413.10 | Facility | None | $70.79 | $165.96 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $165.96 Typical High $275.42 | Professional | None | $70.79 | $165.96 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $67.61 Median $165.96 Typical High $407.38 | Professional | None | $67.61 | $165.96 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $151.36 Typical High $269.15 | Professional | None | $70.79 | $151.36 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $512.86 | Professional | None | $190.55 | $190.55 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $53.70 Median $165.96 Typical High $288.40 | Facility | None | $53.70 | $165.96 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $208.93 | Professional | None | $131.83 | $165.96 | $208.93 |
United Setting Professional Modifier None Typical Low $61.66 Median $141.25 Typical High $245.47 | Professional | None | $61.66 | $141.25 | $245.47 |
6 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 $35.48 Median $64.57 Typical High $83.18 | Professional | 52 · Reduced service | $35.48 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $26.30 Typical High $33.11 | Professional | 53 · Discontinued | $14.13 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $97.72 Typical High $125.89 | Professional | 54 · Surgery only | $52.48 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $19.50 Typical High $25.12 | Professional | 55 · Aftercare only | $10.47 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $13.18 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.08 | $13.18 | $16.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $66.07 Median $83.18 Typical High $144.54 | Professional | 51 · Multiple procedures | $66.07 | $83.18 | $144.54 |
Where North Carolina sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$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.