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 $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $138.04 | Professional | None | $117.49 | $138.04 | $138.04 |
BCBS Setting Facility Modifier None Typical Low $489.78 Median $724.44 Typical High $1,000.00 | Facility | None | $489.78 | $724.44 | $1,000.00 |
BCBS Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $398.11 | Professional | None | $169.82 | $245.47 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $1,000.00 Typical High $1,412.54 | Facility | None | $138.04 | $1,000.00 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $151.36 Typical High $234.42 | Professional | None | $147.91 | $151.36 | $234.42 |
United Setting Professional Modifier None Typical Low $144.54 Median $154.88 Typical High $229.09 | Professional | None | $144.54 | $154.88 | $229.09 |
4 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 54 · Surgery only Typical Low $87.10 Median $104.71 Typical High $104.71 | Professional | 54 · Surgery only | $87.10 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $17.38 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $11.75 | $13.80 | $13.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $75.86 Typical High $199.53 | Professional | 51 · Multiple procedures | $74.13 | $75.86 | $199.53 |
Where North Carolina sits
The same service costs 16.2 times more in Minnesota than in New Jersey. 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· 20th of 51
$214
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.