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 $25.70 Median $25.70 Typical High $58.88 | Facility | None | $25.70 | $25.70 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $42.66 Typical High $60.26 | Professional | None | $25.70 | $42.66 | $60.26 |
BCBS North Carolina Setting Facility Modifier None Typical Low $25.12 Median $38.90 Typical High $100.00 | Facility | None | $25.12 | $38.90 | $100.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $43.65 Median $87.10 Typical High $138.04 | Professional | None | $43.65 | $87.10 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $186.21 | Facility | None | $50.12 | $50.12 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $67.61 Typical High $104.71 | Professional | None | $33.88 | $67.61 | $104.71 |
Medcost Setting Facility Modifier None Typical Low $27.54 Median $42.66 Typical High $58.88 | Facility | None | $27.54 | $42.66 | $58.88 |
Medcost Setting Professional Modifier None Typical Low $54.95 Median $63.10 Typical High $93.33 | Professional | None | $54.95 | $63.10 | $93.33 |
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 $27.54 Median $52.48 Typical High $100.00 | Professional | None | $27.54 | $52.48 | $100.00 |
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 $12.88 Median $20.89 Typical High $29.51 | Professional | 52 · Reduced service | $12.88 | $20.89 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $8.32 Typical High $11.75 | Professional | 53 · Discontinued | $5.25 | $8.32 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $6.31 Typical High $8.71 | Professional | 55 · Aftercare only | $3.89 | $6.31 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $4.17 Typical High $5.89 | Professional | 56 · Pre-op care only | $2.57 | $4.17 | $5.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $28.18 Median $41.69 Typical High $74.13 | Professional | 51 · Multiple procedures | $28.18 | $41.69 | $74.13 |
Where North Carolina sits
The same service costs 3.5 times more in Wisconsin than in Utah. 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· 6th of 51
$72.44
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.