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 $5,011.87 Median $5,011.87 Typical High $5,011.87 | Facility | None | $5,011.87 | $5,011.87 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $4,786.30 Median $5,011.87 Typical High $5,011.87 | Professional | None | $4,786.30 | $5,011.87 | $5,011.87 |
BCBS North Carolina Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
BCBS North Carolina Setting Professional Modifier None Typical Low $45.71 Median $3,981.07 Typical High $3,981.07 | Professional | None | $45.71 | $3,981.07 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $7,079.46 Median $7,413.10 Typical High $10,471.29 | Facility | None | $7,079.46 | $7,413.10 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Medcost Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,248.07 | Facility | None | $5,011.87 | $5,011.87 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $5,754.40 Typical High $5,888.44 | Professional | None | $1,479.11 | $5,754.40 | $5,888.44 |
United Setting Professional Modifier None Typical Low $4,897.79 Median $5,128.61 Typical High $5,128.61 | Professional | None | $4,897.79 | $5,128.61 | $5,128.61 |
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 $2,398.83 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $2,398.83 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $954.99 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $741.31 Typical High $741.31 | Professional | 55 · Aftercare only | $724.44 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $478.63 | $501.19 | $501.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $2,818.38 Typical High $2,818.38 | Professional | 51 · Multiple procedures | $724.44 | $2,818.38 | $2,818.38 |
Where North Carolina sits
The same service costs 1.8 times more in Alaska than in North Carolina. 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· 51st of 51
$3,981
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.