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 $66.07 | Facility | None | $44.67 | $44.67 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $44.67 Typical High $44.67 | Professional | None | $38.02 | $44.67 | $44.67 |
BCBS North Carolina Setting Facility Modifier None Typical Low $56.23 Median $81.28 Typical High $112.20 | Facility | None | $56.23 | $81.28 | $112.20 |
BCBS North Carolina Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $61.66 | Professional | None | $48.98 | $56.23 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $61.66 Typical High $81.28 | Facility | None | $53.70 | $61.66 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $45.71 | Facility | None | $44.67 | $44.67 | $45.71 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $102.33 Typical High $102.33 | Professional | None | $61.66 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $43.65 | Professional | None | $39.81 | $41.69 | $43.65 |
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 $19.05 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $19.05 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $7.59 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $5.75 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.80 | $4.47 | $4.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $51.29 Median $154.88 Typical High $257.04 | Professional | 51 · Multiple procedures | $51.29 | $154.88 | $257.04 |
Where North Carolina sits
The same service costs 1.6 times more in Alaska than in South Carolina. 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
$56.23
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.