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 $42.66 Median $213.80 Typical High $1,288.25 | Facility | None | $42.66 | $213.80 | $1,288.25 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $162.18 Typical High $309.03 | Professional | None | $42.66 | $162.18 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $58.88 Typical High $107.15 | Professional | None | $45.71 | $58.88 | $107.15 |
BCBS North Carolina Setting Professional Modifier None Typical Low $83.18 Median $309.03 Typical High $562.34 | Professional | None | $83.18 | $309.03 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $177.83 Typical High $436.52 | Professional | None | $51.29 | $177.83 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Medcost Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $229.09 | Facility | None | $42.66 | $42.66 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $245.47 Typical High $446.68 | Professional | None | $131.83 | $245.47 | $446.68 |
Oscar Health Setting Professional Modifier None Typical Low $41.69 Median $190.55 Typical High $436.52 | Professional | None | $41.69 | $190.55 | $436.52 |
United Setting Facility Modifier None Typical Low $512.86 Median $891.25 Typical High $2,089.30 | Facility | None | $512.86 | $891.25 | $2,089.30 |
United Setting Professional Modifier None Typical Low $44.67 Median $169.82 Typical High $389.05 | Professional | None | $44.67 | $169.82 | $389.05 |
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 $21.38 Median $77.62 Typical High $104.71 | Professional | 52 · Reduced service | $21.38 | $77.62 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $30.90 Typical High $42.66 | Professional | 53 · Discontinued | $8.51 | $30.90 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $23.44 Typical High $31.62 | Professional | 55 · Aftercare only | $6.46 | $23.44 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $15.49 Typical High $21.38 | Professional | 56 · Pre-op care only | $4.27 | $15.49 | $21.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $100.00 Median $125.89 Typical High $281.84 | Professional | 51 · Multiple procedures | $100.00 | $125.89 | $281.84 |
Where North Carolina sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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· 1st of 51
$309
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.