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 $208.93 Median $208.93 Typical High $7,943.28 | Facility | None | $208.93 | $208.93 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $218.78 | Professional | None | $181.97 | $208.93 | $218.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $616.60 Median $891.25 Typical High $1,258.93 | Facility | None | $616.60 | $891.25 | $1,258.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $204.17 Median $380.19 Typical High $501.19 | Professional | None | $204.17 | $380.19 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $354.81 Typical High $3,388.44 | Facility | None | $208.93 | $354.81 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $177.83 Typical High $354.81 | Professional | None | $173.78 | $177.83 | $354.81 |
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 $91.20 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $91.20 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $36.31 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $158.49 Typical High $158.49 | Professional | 54 · Surgery only | $138.04 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $27.54 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $18.20 | $20.89 | $20.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $87.10 Median $89.13 Typical High $281.84 | Professional | 51 · Multiple procedures | $87.10 | $89.13 | $281.84 |
Where North Carolina sits
The same service costs 25.7 times more in Oklahoma than in Vermont. 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· 17th of 51
$372
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.