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 $57.54 Median $91.20 Typical High $190.55 | Facility | None | $57.54 | $91.20 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $114.82 | Professional | None | $57.54 | $91.20 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $57.54 | Professional | None | $30.90 | $30.90 | $57.54 |
BCBS Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $257.04 | Facility | None | $239.88 | $239.88 | $257.04 |
BCBS Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $79.43 | Professional | None | $51.29 | $51.29 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $251.19 Typical High $524.81 | Facility | None | $72.44 | $251.19 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $60.26 Typical High $147.91 | Professional | None | $38.02 | $60.26 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Medcost Setting Facility Modifier None Typical Low $79.43 Median $91.20 Typical High $120.23 | Facility | None | $79.43 | $91.20 | $120.23 |
Medcost Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $79.43 | Professional | None | $60.26 | $79.43 | $79.43 |
United Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $114.82 | Professional | None | $39.81 | $47.86 | $114.82 |
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 $45.71 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 54 · Surgery only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.12 |
Where North Carolina sits
The same service costs 4.9 times more in Alaska than in Georgia. 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· 34th of 51
$79.43
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.