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 $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
BCBS North Carolina Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $79.43 | Professional | None | $66.07 | $74.13 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | None | $0.91 | $0.91 | $0.91 |
Medcost Setting Professional Modifier None Typical Low $16.98 Median $28.84 Typical High $53.70 | Professional | None | $16.98 | $28.84 | $53.70 |
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 $10.00 Median $10.00 Typical High $10.00 | Professional | 52 · Reduced service | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 53 · Discontinued | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 56 · Pre-op care only | $2.00 | $2.00 | $2.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $8.32 Median $14.45 Typical High $26.92 | Professional | 51 · Multiple procedures | $8.32 | $14.45 | $26.92 |
Where North Carolina sits
The same service costs 87.1 times more in Montana than in West Virginia. 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· 2nd of 51
$74.13
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.