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 $173.78 Median $173.78 Typical High $295.12 | Facility | None | $173.78 | $173.78 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $239.88 | Professional | None | $173.78 | $173.78 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
BCBS North Carolina Setting Facility Modifier None Typical Low $575.44 Median $891.25 Typical High $891.25 | Facility | None | $575.44 | $891.25 | $891.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $501.19 | Professional | None | $131.83 | $154.88 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $478.63 Typical High $1,000.00 | Facility | None | $177.83 | $478.63 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $426.58 | Professional | None | $102.33 | $173.78 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $257.04 | Facility | None | $173.78 | $173.78 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $371.54 | Professional | None | $147.91 | $147.91 | $371.54 |
United Setting Professional Modifier None Typical Low $74.13 Median $131.83 Typical High $223.87 | Professional | None | $74.13 | $131.83 | $223.87 |
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 $87.10 Median $87.10 Typical High $102.33 | Professional | 52 · Reduced service | $87.10 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $41.69 | Professional | 53 · Discontinued | $34.67 | $34.67 | $41.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $74.13 Typical High $302.00 | Professional | 51 · Multiple procedures | $74.13 | $74.13 | $302.00 |
Where North Carolina sits
The same service costs 3.6 times more in Alaska than in Oklahoma. 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· 46th of 51
$162
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.