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 $912.01 Median $1,584.89 Typical High $16,595.87 | Facility | None | $912.01 | $1,584.89 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $9,120.11 | Professional | None | $912.01 | $912.01 | $9,120.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $12,882.50 Median $20,892.96 Typical High $32,359.37 | Facility | None | $12,882.50 | $20,892.96 | $32,359.37 |
Cigna Setting Facility Modifier None Typical Low $15,135.61 Median $22,387.21 Typical High $32,359.37 | Facility | None | $15,135.61 | $22,387.21 | $32,359.37 |
Medcost Setting Facility Modifier None Typical Low $977.24 Median $20,417.38 Typical High $42,657.95 | Facility | None | $977.24 | $20,417.38 | $42,657.95 |
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 $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $91.20 |
Where North Carolina sits
The same service costs 5754.4 times more in Oklahoma than in Maine. 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· 11th of 51
$14,125
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.