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 $41.69 Median $41.69 Typical High $81.28 | Facility | None | $41.69 | $41.69 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $72.44 Typical High $83.18 | Professional | None | $41.69 | $72.44 | $83.18 |
BCBS North Carolina Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $104.71 | Facility | None | $52.48 | $77.62 | $104.71 |
BCBS North Carolina Setting Professional Modifier None Typical Low $64.57 Median $104.71 Typical High $223.87 | Professional | None | $64.57 | $104.71 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $117.49 Typical High $173.78 | Facility | None | $56.23 | $117.49 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $83.18 Typical High $154.88 | Professional | None | $48.98 | $83.18 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $194.98 | Professional | None | $120.23 | $120.23 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $57.54 Median $91.20 Typical High $154.88 | Facility | None | $57.54 | $91.20 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $141.25 | Professional | None | $79.43 | $93.33 | $141.25 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $40.74 Median $75.86 Typical High $144.54 | Professional | None | $40.74 | $75.86 | $144.54 |
6 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 $20.89 Median $36.31 Typical High $42.66 | Professional | 52 · Reduced service | $20.89 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $14.45 Typical High $16.98 | Professional | 53 · Discontinued | $8.32 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $10.96 Typical High $12.59 | Professional | 55 · Aftercare only | $6.31 | $10.96 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $7.24 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.17 | $7.24 | $8.51 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $28.84 Median $45.71 Typical High $75.86 | Facility | 51 · Multiple procedures | $28.84 | $45.71 | $75.86 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $39.81 Median $46.77 Typical High $104.71 | Professional | 51 · Multiple procedures | $39.81 | $46.77 | $104.71 |
Where North Carolina sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 16th of 51
$91.20
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.