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 $12.59 Median $12.59 Typical High $724.44 | Facility | None | $12.59 | $12.59 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $12.59 Typical High $13.18 | Professional | None | $11.75 | $12.59 | $13.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $13.49 Median $32.36 Typical High $316.23 | Professional | None | $13.49 | $32.36 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $199.53 Typical High $346.74 | Professional | None | $20.42 | $199.53 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $16.22 | Facility | None | $12.59 | $12.59 | $16.22 |
Medcost Setting Professional Modifier None Typical Low $21.88 Median $302.00 Typical High $436.52 | Professional | None | $21.88 | $302.00 | $436.52 |
United Setting Professional Modifier None Typical Low $8.71 Median $12.02 Typical High $128.82 | Professional | None | $8.71 | $12.02 | $128.82 |
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 $5.89 Median $6.31 Typical High $6.61 | Professional | 52 · Reduced service | $5.89 | $6.31 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.51 Typical High $2.63 | Professional | 53 · Discontinued | $2.40 | $2.51 | $2.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $1.86 Typical High $2.00 | Professional | 55 · Aftercare only | $1.78 | $1.86 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.26 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.20 | $1.26 | $1.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $36.31 Median $151.36 Typical High $218.78 | Professional | 51 · Multiple procedures | $36.31 | $151.36 | $218.78 |
Where North Carolina sits
The same service costs 43.7 times more in Hawaii 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· 5th of 51
$32.36
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.