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 $16.22 Median $23.44 Typical High $23.44 | Professional | None | $16.22 | $23.44 | $23.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $19.50 Median $21.88 Typical High $21.88 | Professional | None | $19.50 | $21.88 | $21.88 |
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 Facility Modifier None Typical Low $23.44 Median $28.18 Typical High $37.15 | Facility | None | $23.44 | $28.18 | $37.15 |
Medcost Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $41.69 | Professional | None | $19.50 | $19.50 | $41.69 |
United Setting Professional Modifier None Typical Low $9.77 Median $13.18 Typical High $14.79 | Professional | None | $9.77 | $13.18 | $14.79 |
6 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 $8.13 Median $11.75 Typical High $11.75 | Professional | 52 · Reduced service | $8.13 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $4.68 Typical High $4.68 | Professional | 53 · Discontinued | $3.31 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $3.47 Typical High $3.47 | Professional | 55 · Aftercare only | $2.45 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $2.34 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.62 | $2.34 | $2.34 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | KX · Policy requirements met | $21.88 | $21.88 | $21.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $9.77 Median $9.77 Typical High $29.51 | Professional | 51 · Multiple procedures | $9.77 | $9.77 | $29.51 |
Where North Carolina sits
The same service costs 2.6 times more in Hawaii than in Kentucky. 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· 13th 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.