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 $63.10 Median $70.79 Typical High $70.79 | Facility | None | $63.10 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $89.13 | Professional | None | $70.79 | $70.79 | $89.13 |
BCBS North Carolina Setting Facility Modifier None Typical Low $91.20 Median $123.03 Typical High $169.82 | Facility | None | $91.20 | $123.03 | $169.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $102.33 | Professional | None | $93.33 | $93.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $138.04 Typical High $181.97 | Facility | None | $120.23 | $138.04 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $102.33 | Facility | None | $70.79 | $70.79 | $102.33 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $97.72 | Professional | None | $72.44 | $72.44 | $97.72 |
United Setting Professional Modifier None Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | None | $81.28 | $87.10 | $87.10 |
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 $35.48 Median $35.48 Typical High $44.67 | Professional | 52 · Reduced service | $35.48 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $17.78 | Professional | 53 · Discontinued | $14.13 | $14.13 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $13.18 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $8.51 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 51 · Multiple procedures | $36.31 | $36.31 | $36.31 |
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· 6th of 51
$93.33
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.