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 $23.44 Median $38.02 Typical High $38.02 | Facility | None | $23.44 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $33.11 Typical High $39.81 | Professional | None | $23.44 | $33.11 | $39.81 |
BCBS North Carolina Setting Professional Modifier None Typical Low $19.05 Median $30.20 Typical High $46.77 | Professional | None | $19.05 | $30.20 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $33.88 Typical High $47.86 | Professional | None | $18.62 | $33.88 | $47.86 |
Medcost Setting Facility Modifier None Typical Low $22.91 Median $23.44 Typical High $45.71 | Facility | None | $22.91 | $23.44 | $45.71 |
Medcost Setting Professional Modifier None Typical Low $40.74 Median $42.66 Typical High $43.65 | Professional | None | $40.74 | $42.66 | $43.65 |
United Setting Professional Modifier None Typical Low $15.14 Median $24.55 Typical High $39.81 | Professional | None | $15.14 | $24.55 | $39.81 |
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 $11.48 Median $14.45 Typical High $19.05 | Professional | 52 · Reduced service | $11.48 | $14.45 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $5.89 Typical High $7.59 | Professional | 53 · Discontinued | $4.68 | $5.89 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $4.37 Typical High $5.75 | Professional | 55 · Aftercare only | $3.47 | $4.37 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.95 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.29 | $2.95 | $3.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $20.42 Median $21.38 Typical High $21.88 | Professional | 51 · Multiple procedures | $20.42 | $21.38 | $21.88 |
Where North Carolina sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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· 41st of 51
$30.20
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.