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 $144.54 Median $316.23 Typical High $316.23 | Facility | None | $144.54 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | None | $302.00 | $316.23 | $316.23 |
BCBS North Carolina Setting Facility Modifier None Typical Low $416.87 Median $478.63 Typical High $501.19 | Facility | None | $416.87 | $478.63 | $501.19 |
BCBS North Carolina Setting Professional Modifier None Typical Low $45.71 Median $302.00 Typical High $302.00 | Professional | None | $45.71 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $478.63 Typical High $676.08 | Facility | None | $457.09 | $478.63 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Medcost Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $331.13 | Facility | None | $316.23 | $316.23 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $14.13 Median $154.88 Typical High $371.54 | Professional | None | $14.13 | $154.88 | $371.54 |
United Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $331.13 | Professional | None | $309.03 | $331.13 | $331.13 |
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 $151.36 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $151.36 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $60.26 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $45.71 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $30.20 | $31.62 | $31.62 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $7.08 Median $7.94 Typical High $77.62 | Professional | 51 · Multiple procedures | $7.08 | $7.94 | $77.62 |
Where North Carolina sits
The same service costs 2.3 times more in Alaska than in Montana. 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· 50th of 51
$302
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.