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 $47.86 Median $47.86 Typical High $72.44 | Facility | None | $47.86 | $47.86 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $60.26 | Professional | None | $47.86 | $47.86 | $60.26 |
BCBS North Carolina Setting Facility Modifier None Typical Low $61.66 Median $89.13 Typical High $123.03 | Facility | None | $61.66 | $89.13 | $123.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $74.13 | Professional | None | $57.54 | $57.54 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $91.20 Typical High $128.82 | Facility | None | $81.28 | $91.20 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Medcost Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $67.61 | Facility | None | $47.86 | $47.86 | $67.61 |
Medcost Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $74.13 | Professional | None | $45.71 | $45.71 | $74.13 |
United Setting Professional Modifier None Typical Low $54.95 Median $58.88 Typical High $60.26 | Professional | None | $54.95 | $58.88 | $60.26 |
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 $23.99 Median $23.99 Typical High $29.51 | Professional | 52 · Reduced service | $23.99 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $11.75 | Professional | 53 · Discontinued | $9.55 | $9.55 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $8.71 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $5.89 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $48.98 Median $54.95 Typical High $63.10 | Professional | JZ · No drug discarded | $48.98 | $54.95 | $63.10 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 51 · Multiple procedures | $22.39 | $22.39 | $22.39 |
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· 31st of 51
$57.54
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.