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 $43.65 Median $43.65 Typical High $128.82 | Facility | None | $43.65 | $43.65 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $107.15 Typical High $134.90 | Professional | None | $43.65 | $107.15 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
BCBS North Carolina Setting Professional Modifier None Typical Low $63.10 Median $213.80 Typical High $316.23 | Professional | None | $63.10 | $213.80 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $128.82 Typical High $204.17 | Professional | None | $45.71 | $128.82 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $251.19 | Professional | None | $190.55 | $190.55 | $251.19 |
Medcost Setting Facility Modifier None Typical Low $42.66 Median $43.65 Typical High $147.91 | Facility | None | $42.66 | $43.65 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $151.36 | Professional | None | $100.00 | $117.49 | $151.36 |
Oscar Health Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $138.04 | Professional | None | $131.83 | $131.83 | $138.04 |
United Setting Professional Modifier None Typical Low $42.66 Median $102.33 Typical High $194.98 | Professional | None | $42.66 | $102.33 | $194.98 |
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 $21.88 Median $40.74 Typical High $64.57 | Professional | 52 · Reduced service | $21.88 | $40.74 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $16.60 Typical High $25.70 | Professional | 53 · Discontinued | $8.71 | $16.60 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $12.30 Typical High $19.50 | Professional | 55 · Aftercare only | $6.61 | $12.30 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $8.13 Typical High $12.88 | Professional | 56 · Pre-op care only | $4.37 | $8.13 | $12.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $50.12 Median $58.88 Typical High $87.10 | Professional | 51 · Multiple procedures | $50.12 | $58.88 | $87.10 |
Where North Carolina sits
The same service costs 3.5 times more in Wisconsin 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· 5th of 51
$166
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.