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 $32.36 Median $50.12 Typical High $5,248.07 | Facility | None | $32.36 | $50.12 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $46.77 Typical High $64.57 | Professional | None | $32.36 | $46.77 | $64.57 |
Ambetter Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $54.95 | Professional | None | $47.86 | $47.86 | $54.95 |
BCBS North Carolina Setting Professional Modifier None Typical Low $50.12 Median $77.62 Typical High $144.54 | Professional | None | $50.12 | $77.62 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $870.96 Typical High $2,454.71 | Facility | None | $645.65 | $870.96 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Medcost Setting Facility Modifier None Typical Low $30.90 Median $52.48 Typical High $81.28 | Facility | None | $30.90 | $52.48 | $81.28 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $45.71 Typical High $85.11 | Professional | None | $44.67 | $45.71 | $85.11 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $33.11 Median $50.12 Typical High $102.33 | Professional | None | $33.11 | $50.12 | $102.33 |
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 $16.22 Median $18.62 Typical High $25.12 | Professional | 52 · Reduced service | $16.22 | $18.62 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.59 Typical High $10.23 | Professional | 53 · Discontinued | $6.46 | $7.59 | $10.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $28.18 Typical High $38.02 | Professional | 54 · Surgery only | $24.55 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.62 Typical High $7.59 | Professional | 55 · Aftercare only | $4.90 | $5.62 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.80 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.24 | $3.80 | $5.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.39 Median $22.39 Typical High $70.79 | Professional | 51 · Multiple procedures | $22.39 | $22.39 | $70.79 |
Where North Carolina sits
The same service costs 2.8 times more in Alaska than in California. 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· 8th of 51
$72.44
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.