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 $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $741.31 Typical High $741.31 | Professional | None | $234.42 | $741.31 | $741.31 |
BCBS North Carolina Setting Professional Modifier None Typical Low $204.17 Median $389.05 Typical High $707.95 | Professional | None | $204.17 | $389.05 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $776.25 Typical High $1,174.90 | Facility | None | $741.31 | $776.25 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $501.19 | Professional | None | $204.17 | $204.17 | $501.19 |
United Setting Professional Modifier None Typical Low $64.57 Median $125.89 Typical High $389.05 | Professional | None | $64.57 | $125.89 | $389.05 |
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 $117.49 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $117.49 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $46.77 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $35.48 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $23.44 | $74.13 | $74.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $102.33 Typical High $251.19 | Professional | 51 · Multiple procedures | $102.33 | $102.33 | $251.19 |
Where North Carolina sits
The same service costs 7.6 times more in Colorado 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· 8th of 51
$363
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.