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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $50.12 Typical High $50.12 | Professional | None | $47.86 | $50.12 | $50.12 |
BCBS North Carolina Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $158.49 | Facility | None | $131.83 | $131.83 | $158.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $60.26 | Professional | None | $45.71 | $50.12 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $77.62 Typical High $109.65 | Facility | None | $74.13 | $77.62 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Medcost Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $53.70 | Facility | None | $50.12 | $50.12 | $53.70 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $58.88 | Professional | None | $50.12 | $50.12 | $58.88 |
United Setting Professional Modifier None Typical Low $58.88 Median $63.10 Typical High $63.10 | Professional | None | $58.88 | $63.10 | $63.10 |
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 $23.99 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $23.99 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $9.77 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.24 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.79 | $5.01 | $5.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 51 · Multiple procedures | $25.12 | $25.12 | $25.12 |
Where North Carolina sits
The same service costs 1.6 times more in Alaska than in Pennsylvania. 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· 49th of 51
$50.12
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.