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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $70.79 Typical High $70.79 | Professional | None | $15.14 | $70.79 | $70.79 |
BCBS North Carolina Setting Professional Modifier None Typical Low $13.18 Median $27.54 Typical High $100.00 | Professional | None | $13.18 | $27.54 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $83.18 | Facility | None | $70.79 | $70.79 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $9.33 Median $14.13 Typical High $14.13 | Professional | None | $9.33 | $14.13 | $14.13 |
United Setting Professional Modifier None Typical Low $12.88 Median $15.14 Typical High $26.30 | Professional | None | $12.88 | $15.14 | $26.30 |
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 $7.59 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $7.59 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $3.02 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $2.24 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $1.51 | $7.08 | $7.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4.57 Median $7.08 Typical High $7.08 | Professional | 51 · Multiple procedures | $4.57 | $7.08 | $7.08 |
Where North Carolina sits
The same service costs 4.9 times more in Alaska than in Connecticut. 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· 13th of 51
$20.42
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.