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 $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $23.44 Typical High $23.44 | Professional | None | $16.98 | $23.44 | $23.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $18.62 Median $21.88 Typical High $23.44 | Professional | None | $18.62 | $21.88 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Medcost Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Medcost Setting Facility Modifier None Typical Low $23.44 Median $30.90 Typical High $44.67 | Facility | None | $23.44 | $30.90 | $44.67 |
Medcost Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $41.69 | Professional | None | $23.99 | $23.99 | $41.69 |
United Setting Professional Modifier None Typical Low $9.77 Median $13.18 Typical High $16.22 | Professional | None | $9.77 | $13.18 | $16.22 |
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 $2.51 Median $3.47 Typical High $3.47 | Professional | 55 · Aftercare only | $2.51 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $2.34 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.66 | $2.34 | $2.34 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $11.75 Median $12.02 Typical High $29.51 | Professional | 51 · Multiple procedures | $11.75 | $12.02 | $29.51 |
Where North Carolina sits
The same service costs 2.5 times more in Hawaii 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· 14th of 51
$21.88
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.