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 $57.54 Median $100.00 Typical High $100.00 | Facility | None | $57.54 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $102.33 | Professional | None | $57.54 | $81.28 | $102.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $47.86 Median $66.07 Typical High $114.82 | Professional | None | $47.86 | $66.07 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $93.33 | Professional | None | $46.77 | $67.61 | $93.33 |
Medcost Setting Facility Modifier None Typical Low $56.23 Median $57.54 Typical High $114.82 | Facility | None | $56.23 | $57.54 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $93.33 | Professional | None | $56.23 | $60.26 | $93.33 |
Oscar Health Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $30.20 Median $51.29 Typical High $95.50 | Professional | None | $30.20 | $51.29 | $95.50 |
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 $28.84 Median $37.15 Typical High $50.12 | Professional | 52 · Reduced service | $28.84 | $37.15 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $14.79 Typical High $19.95 | Professional | 53 · Discontinued | $11.48 | $14.79 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $11.22 Typical High $14.79 | Professional | 55 · Aftercare only | $8.71 | $11.22 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.41 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.75 | $7.41 | $10.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $28.18 Median $28.18 Typical High $46.77 | Professional | 51 · Multiple procedures | $28.18 | $28.18 | $46.77 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where North Carolina sits
The same service costs 3.0 times more in Alaska than in Florida. 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· 47th of 51
$66.07
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.