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 $67.61 Median $67.61 Typical High $138.04 | Facility | None | $67.61 | $67.61 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | None | $67.61 | $67.61 | $81.28 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
BCBS North Carolina Setting Facility Modifier None Typical Low $89.13 Median $128.82 Typical High $154.88 | Facility | None | $89.13 | $128.82 | $154.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $87.10 | Professional | None | $60.26 | $79.43 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $123.03 Typical High $173.78 | Facility | None | $107.15 | $123.03 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Medcost Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $91.20 | Facility | None | $67.61 | $67.61 | $91.20 |
Medcost Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $91.20 | Professional | None | $53.70 | $53.70 | $91.20 |
United Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $79.43 | Professional | None | $75.86 | $79.43 | $79.43 |
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 $33.11 Median $33.11 Typical High $39.81 | Professional | 52 · Reduced service | $33.11 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $15.85 | Professional | 53 · Discontinued | $13.49 | $13.49 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $50.12 Typical High $58.88 | Professional | 54 · Surgery only | $50.12 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $11.75 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.94 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 51 · Multiple procedures | $26.92 | $26.92 | $26.92 |
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· 14th of 51
$79.43
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.