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 $213.80 Median $213.80 Typical High $512.86 | Facility | None | $213.80 | $213.80 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | None | $213.80 | $213.80 | $295.12 |
BCBS North Carolina Setting Facility Modifier None Typical Low $309.03 Median $426.58 Typical High $549.54 | Facility | None | $309.03 | $426.58 | $549.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $147.91 Median $275.42 Typical High $302.00 | Professional | None | $147.91 | $275.42 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $446.68 Typical High $630.96 | Facility | None | $398.11 | $446.68 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Medcost Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $331.13 | Facility | None | $213.80 | $213.80 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $316.23 | Professional | None | $100.00 | $100.00 | $316.23 |
United Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $281.84 | Professional | None | $269.15 | $281.84 | $281.84 |
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 $107.15 Median $107.15 Typical High $144.54 | Professional | 52 · Reduced service | $107.15 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | 53 · Discontinued | $42.66 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $42.66 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $28.84 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $28.84 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | JW · Drug discarded | $281.84 | $281.84 | $281.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 51 · Multiple procedures | $48.98 | $48.98 | $48.98 |
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
$275
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.