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 $416,869.38 Median $416,869.38 Typical High $416,869.38 | Facility | None | $416,869.38 | $416,869.38 | $416,869.38 |
Aetna Setting Professional Modifier None Typical Low $416,869.38 Median $416,869.38 Typical High $512,861.38 | Professional | None | $416,869.38 | $416,869.38 | $512,861.38 |
BCBS North Carolina Setting Facility Modifier None Typical Low $549,540.87 Median $794,328.23 Typical High $1,000,000.00 | Facility | None | $549,540.87 | $794,328.23 | $1,000,000.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $512,861.38 Median $512,861.38 Typical High $602,559.59 | Professional | None | $512,861.38 | $512,861.38 | $602,559.59 |
Medcost Setting Facility Modifier None Typical Low $416,869.38 Median $416,869.38 Typical High $602,559.59 | Facility | None | $416,869.38 | $416,869.38 | $602,559.59 |
Medcost Setting Professional Modifier None Typical Low $354,813.39 Median $354,813.39 Typical High $602,559.59 | Professional | None | $354,813.39 | $354,813.39 | $602,559.59 |
United Setting Professional Modifier None Typical Low $489,778.82 Median $489,778.82 Typical High $630,957.34 | Professional | None | $489,778.82 | $489,778.82 | $630,957.34 |
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 $208,929.61 Median $208,929.61 Typical High $257,039.58 | Professional | 52 · Reduced service | $208,929.61 | $208,929.61 | $257,039.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83,176.38 Median $83,176.38 Typical High $102,329.30 | Professional | 53 · Discontinued | $83,176.38 | $83,176.38 | $102,329.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63,095.73 Median $63,095.73 Typical High $77,624.71 | Professional | 55 · Aftercare only | $63,095.73 | $63,095.73 | $77,624.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41,686.94 Median $41,686.94 Typical High $51,286.14 | Professional | 56 · Pre-op care only | $41,686.94 | $41,686.94 | $51,286.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125,892.54 Median $177,827.94 Typical High $177,827.94 | Professional | 51 · Multiple procedures | $125,892.54 | $177,827.94 | $177,827.94 |
Where North Carolina sits
The same service costs 2.0 times more in Texas 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· 40th of 51
$512,861
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.