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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $93.33 | Professional | None | $91.20 | $91.20 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $141.25 | Professional | None | $93.33 | $93.33 | $141.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $67.61 Median $104.71 Typical High $158.49 | Professional | None | $67.61 | $104.71 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $112.20 | Facility | None | $91.20 | $91.20 | $112.20 |
Medcost Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $93.33 | Professional | None | $66.07 | $93.33 | $93.33 |
Oscar Health Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $218.78 | Professional | None | $162.18 | $181.97 | $218.78 |
United Setting Professional Modifier None Typical Low $81.28 Median $91.20 Typical High $151.36 | Professional | None | $81.28 | $91.20 | $151.36 |
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 $45.71 Median $45.71 Typical High $46.77 | Professional | 52 · Reduced service | $45.71 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $14.13 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.33 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.11 Median $46.77 Typical High $46.77 | Professional | 51 · Multiple procedures | $33.11 | $46.77 | $46.77 |
Where North Carolina sits
The same service costs 3.3 times more in Alaska 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· 20th of 51
$100
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.