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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $42.66 Typical High $42.66 | Professional | None | $33.88 | $42.66 | $42.66 |
BCBS North Carolina Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $33.88 | Professional | None | $30.90 | $30.90 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medcost Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $44.67 | Facility | None | $42.66 | $42.66 | $44.67 |
Medcost Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $47.86 | Professional | None | $28.84 | $44.67 | $47.86 |
United Setting Professional Modifier None Typical Low $17.78 Median $26.30 Typical High $34.67 | Professional | None | $17.78 | $26.30 | $34.67 |
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 $5.13 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $5.13 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.39 | $4.27 | $4.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.45 Median $22.39 Typical High $28.84 | Professional | 51 · Multiple procedures | $14.45 | $22.39 | $28.84 |
Where North Carolina sits
The same service costs 3.0 times more in Montana 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· 43rd of 51
$30.90
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.