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 $1.95 Median $1.95 Typical High $1.95 | Facility | None | $1.95 | $1.95 | $1.95 |
Aetna Setting Professional Modifier None Typical Low $1.55 Median $1.95 Typical High $1.95 | Professional | None | $1.55 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.23 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.16 | $0.19 | $0.19 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1.91 Median $2.51 Typical High $2.51 | Facility | None | $1.91 | $2.51 | $2.51 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1.35 Median $1.41 Typical High $1.86 | Professional | None | $1.35 | $1.41 | $1.86 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Medcost Setting Facility Modifier None Typical Low $1.95 Median $2.34 Typical High $5.50 | Facility | None | $1.95 | $2.34 | $5.50 |
Medcost Setting Professional Modifier None Typical Low $1.00 Median $2.00 Typical High $3.80 | Professional | None | $1.00 | $2.00 | $3.80 |
United Setting Professional Modifier None Typical Low $0.79 Median $1.20 Typical High $1.51 | Professional | None | $0.79 | $1.20 | $1.51 |
1 more rate 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.50 Median $1.00 Typical High $2.75 | Professional | 51 · Multiple procedures | $0.50 | $1.00 | $2.75 |
Where North Carolina sits
The same service costs 6.0 times more in Minnesota than in Rhode Island. 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· 47th of 51
$1.41
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.