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 $28.18 Median $28.18 Typical High $81.28 | Facility | None | $28.18 | $28.18 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $70.79 Typical High $93.33 | Professional | None | $28.18 | $70.79 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | None | $194.98 | $218.78 | $218.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $44.67 Median $147.91 Typical High $275.42 | Professional | None | $44.67 | $147.91 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $87.10 Typical High $151.36 | Professional | None | $30.90 | $87.10 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Medcost Setting Facility Modifier None Typical Low $27.54 Median $28.18 Typical High $95.50 | Facility | None | $27.54 | $28.18 | $95.50 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $102.33 | Professional | None | $64.57 | $85.11 | $102.33 |
Oscar Health Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | None | $91.20 | $91.20 | $97.72 |
United Setting Professional Modifier None Typical Low $28.18 Median $67.61 Typical High $151.36 | Professional | None | $28.18 | $67.61 | $151.36 |
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 $14.13 Median $29.51 Typical High $40.74 | Professional | 52 · Reduced service | $14.13 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $11.75 Typical High $16.22 | Professional | 53 · Discontinued | $5.62 | $11.75 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $10.23 Typical High $12.30 | Professional | 55 · Aftercare only | $4.27 | $10.23 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $5.89 Typical High $8.13 | Professional | 56 · Pre-op care only | $2.82 | $5.89 | $8.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $32.36 Median $42.66 Typical High $61.66 | Professional | 51 · Multiple procedures | $32.36 | $42.66 | $61.66 |
Where North Carolina sits
The same service costs 3.6 times more in North Carolina than in Washington, DC. 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· 1st of 51
$123
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.