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 $14.45 Median $14.45 Typical High $26.92 | Facility | None | $14.45 | $14.45 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $18.20 | Professional | None | $14.45 | $14.45 | $18.20 |
BCBS North Carolina Setting Facility Modifier None Typical Low $16.98 Median $25.12 Typical High $33.88 | Facility | None | $16.98 | $25.12 | $33.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $11.48 Median $16.98 Typical High $19.05 | Professional | None | $11.48 | $16.98 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $27.54 Typical High $38.90 | Facility | None | $23.99 | $27.54 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Medcost Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $20.42 | Facility | None | $14.45 | $14.45 | $20.42 |
Medcost Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $19.50 | Professional | None | $10.23 | $10.23 | $19.50 |
United Setting Professional Modifier None Typical Low $16.98 Median $18.20 Typical High $18.20 | Professional | None | $16.98 | $18.20 | $18.20 |
6 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 $7.24 Median $7.24 Typical High $8.91 | Professional | 52 · Reduced service | $7.24 | $7.24 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $3.55 | Professional | 53 · Discontinued | $2.88 | $2.88 | $3.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $2.63 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.78 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | JZ · No drug discarded | $19.05 | $19.05 | $19.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 51 · Multiple procedures | $5.13 | $5.13 | $5.13 |
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· 51st of 51
$16.98
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.