How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $275.42 Median $275.42 Typical High $776.25 | Facility | None | $275.42 | $275.42 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $416.87 | Professional | None | $275.42 | $275.42 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,230.27 | Facility | None | $776.25 | $1,047.13 | $1,230.27 |
BCBS North Carolina Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $616.60 | Professional | None | $309.03 | $426.58 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $758.58 Typical High $1,584.89 | Facility | None | $288.40 | $758.58 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $316.23 Typical High $512.86 | Professional | None | $158.49 | $316.23 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $407.38 | Facility | None | $275.42 | $275.42 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $691.83 | Professional | None | $467.74 | $467.74 | $691.83 |
United Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $467.74 | Professional | None | $144.54 | $234.42 | $467.74 |
3 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 $138.04 Median $138.04 Typical High $208.93 | Professional | 52 · Reduced service | $138.04 | $138.04 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $83.18 | Professional | 53 · Discontinued | $54.95 | $54.95 | $83.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $234.42 Typical High $478.63 | Professional | 51 · Multiple procedures | $234.42 | $234.42 | $478.63 |
Where North Carolina sits
The same service costs 4.6 times more in Texas than in Alabama. 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· 13th of 51
$427
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.