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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $45.71 Typical High $45.71 | Professional | None | $31.62 | $45.71 | $45.71 |
Ambetter Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | None | $33.88 | $33.88 | $39.81 |
BCBS North Carolina Setting Professional Modifier None Typical Low $37.15 Median $42.66 Typical High $45.71 | Professional | None | $37.15 | $42.66 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Medcost Setting Facility Modifier None Typical Low $45.71 Median $58.88 Typical High $91.20 | Facility | None | $45.71 | $58.88 | $91.20 |
Medcost Setting Professional Modifier None Typical Low $35.48 Median $48.98 Typical High $79.43 | Professional | None | $35.48 | $48.98 | $79.43 |
United Setting Professional Modifier None Typical Low $18.62 Median $26.30 Typical High $33.11 | Professional | None | $18.62 | $26.30 | $33.11 |
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 $4.90 Median $6.76 Typical High $6.76 | Professional | 55 · Aftercare only | $4.90 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.31 | $4.47 | $4.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $24.55 Median $24.55 Typical High $56.23 | Professional | 51 · Multiple procedures | $24.55 | $24.55 | $56.23 |
Where North Carolina sits
The same service costs 5.5 times more in Wyoming than in Utah. 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· 15th of 51
$42.66
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.