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 $478,630.09 Median $478,630.09 Typical High $478,630.09 | Facility | None | $478,630.09 | $478,630.09 | $478,630.09 |
Aetna Setting Professional Modifier None Typical Low $478,630.09 Median $478,630.09 Typical High $588,843.66 | Professional | None | $478,630.09 | $478,630.09 | $588,843.66 |
BCBS North Carolina Setting Facility Modifier None Typical Low $630,957.34 Median $912,010.84 Typical High $1,230,268.77 | Facility | None | $630,957.34 | $912,010.84 | $1,230,268.77 |
BCBS North Carolina Setting Professional Modifier None Typical Low $588,843.66 Median $588,843.66 Typical High $676,082.98 | Professional | None | $588,843.66 | $588,843.66 | $676,082.98 |
Medcost Setting Facility Modifier None Typical Low $478,630.09 Median $478,630.09 Typical High $691,830.97 | Facility | None | $478,630.09 | $478,630.09 | $691,830.97 |
Medcost Setting Professional Modifier None Typical Low $407,380.28 Median $407,380.28 Typical High $676,082.98 | Professional | None | $407,380.28 | $407,380.28 | $676,082.98 |
United Setting Professional Modifier None Typical Low $562,341.33 Median $562,341.33 Typical High $724,435.96 | Professional | None | $562,341.33 | $562,341.33 | $724,435.96 |
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 $239,883.29 Median $239,883.29 Typical High $295,120.92 | Professional | 52 · Reduced service | $239,883.29 | $239,883.29 | $295,120.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95,499.26 Median $95,499.26 Typical High $117,489.76 | Professional | 53 · Discontinued | $95,499.26 | $95,499.26 | $117,489.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72,443.60 Median $72,443.60 Typical High $87,096.36 | Professional | 55 · Aftercare only | $72,443.60 | $72,443.60 | $87,096.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47,863.01 Median $47,863.01 Typical High $58,884.37 | Professional | 56 · Pre-op care only | $47,863.01 | $47,863.01 | $58,884.37 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $144,543.98 Median $204,173.79 Typical High $204,173.79 | Professional | 51 · Multiple procedures | $144,543.98 | $204,173.79 | $204,173.79 |
Where North Carolina sits
The same service costs 1.7 times more in Texas than in Minnesota. 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· 20th of 51
$588,844
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.