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 $44.67 Median $44.67 Typical High $93.33 | Facility | None | $44.67 | $44.67 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $66.07 | Professional | None | $44.67 | $44.67 | $66.07 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
BCBS North Carolina Setting Facility Modifier None Typical Low $64.57 Median $102.33 Typical High $117.49 | Facility | None | $64.57 | $102.33 | $117.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $35.48 Median $58.88 Typical High $64.57 | Professional | None | $35.48 | $58.88 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $97.72 Typical High $134.90 | Facility | None | $85.11 | $97.72 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Medcost Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $72.44 | Facility | None | $44.67 | $44.67 | $72.44 |
Medcost Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $75.86 | Professional | None | $29.51 | $29.51 | $75.86 |
United Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $61.66 | Professional | None | $56.23 | $60.26 | $61.66 |
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 $22.39 Median $22.39 Typical High $30.90 | Professional | 52 · Reduced service | $22.39 | $22.39 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $12.30 | Professional | 53 · Discontinued | $8.91 | $8.91 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $9.33 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $6.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 51 · Multiple procedures | $14.79 | $14.79 | $14.79 |
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· 50th of 51
$58.88
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.