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 $288.40 Median $288.40 Typical High $741.31 | Facility | None | $288.40 | $288.40 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $338.84 | Professional | None | $288.40 | $288.40 | $338.84 |
BCBS North Carolina Setting Facility Modifier None Typical Low $363.08 Median $524.81 Typical High $724.44 | Facility | None | $363.08 | $524.81 | $724.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | None | $338.84 | $338.84 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $524.81 Typical High $691.83 | Facility | None | $467.74 | $524.81 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $389.05 | Facility | None | $288.40 | $288.40 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $389.05 | Professional | None | $251.19 | $251.19 | $389.05 |
United Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | None | $323.59 | $338.84 | $338.84 |
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 $144.54 Median $144.54 Typical High $169.82 | Professional | 52 · Reduced service | $144.54 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $67.61 | Professional | 53 · Discontinued | $57.54 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $51.29 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $33.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 51 · Multiple procedures | $123.03 | $123.03 | $123.03 |
Where North Carolina sits
Rates are fairly even across states for this service. 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· 11th of 51
$339
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.