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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $186.21 Typical High $186.21 | Professional | None | $104.71 | $186.21 | $186.21 |
BCBS North Carolina Setting Facility Modifier None Typical Low $128.82 Median $173.78 Typical High $251.19 | Facility | None | $128.82 | $173.78 | $251.19 |
BCBS North Carolina Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $1,174.90 | Professional | None | $128.82 | $141.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $169.82 Typical High $223.87 | Facility | None | $147.91 | $169.82 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $186.21 | Facility | None | $125.89 | $125.89 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $467.74 Typical High $467.74 | Professional | None | $239.88 | $467.74 | $467.74 |
United Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $131.83 | Professional | None | $120.23 | $128.82 | $131.83 |
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 $52.48 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $52.48 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $20.89 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $15.85 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.47 | $18.62 | $18.62 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $229.09 Median $229.09 Typical High $776.25 | Professional | 51 · Multiple procedures | $229.09 | $229.09 | $776.25 |
Where North Carolina sits
The same service costs 1.9 times more in Wyoming than in Vermont. 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· 8th of 51
$129
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.