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 $125.89 Median $125.89 Typical High $234.42 | Facility | None | $125.89 | $125.89 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $125.89 Typical High $125.89 | Professional | None | $60.26 | $125.89 | $125.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $79.43 Median $109.65 Typical High $158.49 | Facility | None | $79.43 | $109.65 | $158.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | None | $138.04 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $95.50 Typical High $134.90 | Facility | None | $85.11 | $95.50 | $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 $70.79 Median $70.79 Typical High $125.89 | Facility | None | $70.79 | $70.79 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $102.33 | Professional | None | $93.33 | $93.33 | $102.33 |
United Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $85.11 | Professional | None | $77.62 | $81.28 | $85.11 |
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 $30.20 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $30.20 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $12.02 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $8.91 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $6.03 | $12.59 | $12.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $46.77 Median $46.77 Typical High $47.86 | Professional | 51 · Multiple procedures | $46.77 | $46.77 | $47.86 |
Where North Carolina sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 4th 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.