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 $37.15 Median $37.15 Typical High $107.15 | Facility | None | $37.15 | $37.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $37.15 Typical High $37.15 | Professional | None | $28.84 | $37.15 | $37.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $28.18 Median $44.67 Typical High $51.29 | Facility | None | $28.18 | $44.67 | $51.29 |
BCBS North Carolina Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $79.43 | Professional | None | $44.67 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $46.77 Typical High $61.66 | Facility | None | $40.74 | $46.77 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Medcost Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Medcost Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $37.15 | Facility | None | $34.67 | $34.67 | $37.15 |
Medcost Setting Professional Modifier None Typical Low $16.98 Median $79.43 Typical High $97.72 | Professional | None | $16.98 | $79.43 | $97.72 |
United Setting Professional Modifier None Typical Low $24.55 Median $26.30 Typical High $27.54 | Professional | None | $24.55 | $26.30 | $27.54 |
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 $14.45 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $14.45 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $5.75 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $4.37 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.88 | $3.72 | $3.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $8.51 Median $44.67 Typical High $48.98 | Professional | 51 · Multiple procedures | $8.51 | $44.67 | $48.98 |
Where North Carolina sits
The same service costs 2.8 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· 3rd of 51
$37.15
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.