How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $213.80 Median $218.78 Typical High $218.78 | Facility | None | $213.80 | $218.78 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $257.04 | Professional | None | $218.78 | $218.78 | $257.04 |
BCBS North Carolina Setting Facility Modifier None Typical Low $239.88 Median $251.19 Typical High $407.38 | Facility | None | $239.88 | $251.19 | $407.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $309.03 | Professional | None | $269.15 | $269.15 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $407.38 Typical High $575.44 | Facility | None | $380.19 | $407.38 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $354.81 Typical High $933.25 | Facility | None | $218.78 | $354.81 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $371.54 | Professional | None | $190.55 | $190.55 | $371.54 |
United Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
5 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 $109.65 Median $109.65 Typical High $128.82 | Professional | 52 · Reduced service | $109.65 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $51.29 | Professional | 53 · Discontinued | $44.67 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $38.02 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $25.70 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $25.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 51 · Multiple procedures | $95.50 | $95.50 | $95.50 |
Where North Carolina sits
The same service costs 1.7 times more in Alaska than in Indiana. 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· 17th of 51
$269
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.