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 $676.08 Median $794.33 Typical High $16,218.10 | Facility | None | $676.08 | $794.33 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $9,549.93 | Professional | None | $676.08 | $676.08 | $9,549.93 |
BCBS North Carolina Setting Facility Modifier None Typical Low $6,165.95 Median $10,000.00 Typical High $15,848.93 | Facility | None | $6,165.95 | $10,000.00 | $15,848.93 |
Cigna Setting Facility Modifier None Typical Low $8,709.64 Median $13,182.57 Typical High $27,542.29 | Facility | None | $8,709.64 | $13,182.57 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $10,964.78 Typical High $23,442.29 | Facility | None | $707.95 | $10,964.78 | $23,442.29 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,471.29 Typical High $28,183.83 | Facility | None | $1,621.81 | $10,471.29 | $28,183.83 |
5 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 $338.84 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $67.61 |
Where North Carolina sits
The same service costs 281.8 times more in Minnesota than in Montana. 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· 19th of 51
$9,120
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.