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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $489.78 | Professional | None | $467.74 | $489.78 | $489.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,584.89 | Facility | None | $1,318.26 | $1,513.56 | $1,584.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $45.71 Median $512.86 Typical High $512.86 | Professional | None | $45.71 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $758.58 Typical High $1,071.52 | Facility | None | $724.44 | $758.58 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $512.86 | Facility | None | $489.78 | $489.78 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $575.44 | Professional | None | $501.19 | $501.19 | $575.44 |
United Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $616.60 | Professional | None | $575.44 | $616.60 | $616.60 |
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 $234.42 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $234.42 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $93.33 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $70.79 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $46.77 | $48.98 | $48.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $251.19 Typical High $251.19 | Professional | 51 · Multiple procedures | $141.25 | $251.19 | $251.19 |
Where North Carolina sits
The same service costs 1.6 times more in Alaska than in Idaho. 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· 25th of 51
$513
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.