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 $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $5.50 Typical High $5.50 | Professional | None | $4.37 | $5.50 | $5.50 |
BCBS North Carolina Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Professional | None | $3.98 | $3.98 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Medcost Setting Facility Modifier None Typical Low $5.50 Median $6.61 Typical High $16.22 | Facility | None | $5.50 | $6.61 | $16.22 |
Medcost Setting Professional Modifier None Typical Low $5.62 Median $6.92 Typical High $12.59 | Professional | None | $5.62 | $6.92 | $12.59 |
United Setting Professional Modifier None Typical Low $2.29 Median $3.47 Typical High $4.57 | Professional | None | $2.29 | $3.47 | $4.57 |
3 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 55 · Aftercare only Typical Low $0.66 Median $0.81 Typical High $0.81 | Professional | 55 · Aftercare only | $0.66 | $0.81 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.55 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.44 | $0.55 | $0.55 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.82 Median $3.98 Typical High $7.76 | Professional | 51 · Multiple procedures | $2.82 | $3.98 | $7.76 |
Where North Carolina sits
The same service costs 3.2 times more in Montana than in Colorado. 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· 27th of 51
$3.98
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.