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 $2.63 Median $9.12 Typical High $12.30 | Facility | None | $2.63 | $9.12 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $9.12 Typical High $9.12 | Professional | None | $8.13 | $9.12 | $9.12 |
BCBS North Carolina Setting Facility Modifier None Typical Low $8.91 Median $8.91 Typical High $10.72 | Facility | None | $8.91 | $8.91 | $10.72 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3.09 Median $7.24 Typical High $11.75 | Professional | None | $3.09 | $7.24 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $9.12 Median $12.30 Typical High $17.38 | Facility | None | $9.12 | $12.30 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Medcost Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | None | $1.17 | $1.17 | $1.17 |
Medcost Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $9.55 | Facility | None | $9.12 | $9.12 | $9.55 |
Medcost Setting Professional Modifier None Typical Low $1.82 Median $2.00 Typical High $11.75 | Professional | None | $1.82 | $2.00 | $11.75 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
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 $4.07 Median $4.57 Typical High $4.57 | Professional | 52 · Reduced service | $4.07 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.82 Typical High $1.82 | Professional | 53 · Discontinued | $1.62 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.38 Typical High $1.38 | Professional | 55 · Aftercare only | $1.23 | $1.38 | $1.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.91 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.81 | $0.91 | $0.91 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.91 Median $1.00 Typical High $3.47 | Professional | 51 · Multiple procedures | $0.91 | $1.00 | $3.47 |
Where North Carolina sits
Rates are fairly even across states for this service. 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· 51st of 51
$7.24
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.