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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $93.33 Typical High $93.33 | Professional | None | $58.88 | $93.33 | $93.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $52.48 Median $100.00 Typical High $186.21 | Professional | None | $52.48 | $100.00 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $112.20 | Facility | None | $93.33 | $93.33 | $112.20 |
Medcost Setting Professional Modifier None Typical Low $36.31 Median $56.23 Typical High $56.23 | Professional | None | $36.31 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $102.33 | Professional | None | $53.70 | $63.10 | $102.33 |
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 $29.51 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $29.51 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $12.02 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $8.91 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.03 | $9.33 | $9.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $18.20 Median $28.18 Typical High $28.18 | Professional | 51 · Multiple procedures | $18.20 | $28.18 | $28.18 |
Where North Carolina sits
The same service costs 3.0 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· 11th of 51
$81.28
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.