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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $213.80 | Professional | None | $181.97 | $181.97 | $213.80 |
BCBS North Carolina Setting Facility Modifier None Typical Low $223.87 Median $331.13 Typical High $446.68 | Facility | None | $223.87 | $331.13 | $446.68 |
BCBS North Carolina Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $234.42 | Professional | None | $213.80 | $213.80 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $331.13 Typical High $467.74 | Facility | None | $288.40 | $331.13 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $245.47 | Facility | None | $181.97 | $181.97 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $234.42 | Professional | None | $151.36 | $151.36 | $234.42 |
United Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | None | $199.53 | $213.80 | $213.80 |
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 $91.20 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $91.20 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $42.66 | Professional | 53 · Discontinued | $36.31 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $21.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 51 · Multiple procedures | $75.86 | $75.86 | $75.86 |
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
$214
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.