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 $24.55 Median $24.55 Typical High $50.12 | Facility | None | $24.55 | $24.55 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $34.67 | Professional | None | $24.55 | $24.55 | $34.67 |
BCBS North Carolina Setting Facility Modifier None Typical Low $19.95 Median $23.99 Typical High $34.67 | Facility | None | $19.95 | $23.99 | $34.67 |
BCBS North Carolina Setting Professional Modifier None Typical Low $17.78 Median $19.50 Typical High $30.90 | Professional | None | $17.78 | $19.50 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $39.81 Typical High $52.48 | Facility | None | $34.67 | $39.81 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Medcost Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $29.51 | Facility | None | $24.55 | $24.55 | $29.51 |
Medcost Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $46.77 | Professional | None | $28.18 | $28.18 | $46.77 |
United Setting Professional Modifier None Typical Low $16.60 Median $17.78 Typical High $18.62 | Professional | None | $16.60 | $17.78 | $18.62 |
6 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 $12.02 Median $12.02 Typical High $13.18 | Professional | 52 · Reduced service | $12.02 | $12.02 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $5.25 | Professional | 53 · Discontinued | $4.90 | $4.90 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $3.89 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.63 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $16.60 Median $16.60 Typical High $25.12 | Professional | JZ · No drug discarded | $16.60 | $16.60 | $25.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.13 Median $100.00 Typical High $158.49 | Professional | 51 · Multiple procedures | $14.13 | $100.00 | $158.49 |
Where North Carolina sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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· 48th of 51
$24.55
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.