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 $32.36 Median $32.36 Typical High $79.43 | Facility | None | $32.36 | $32.36 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $39.81 | Professional | None | $32.36 | $32.36 | $39.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $40.74 Median $63.10 Typical High $81.28 | Facility | None | $40.74 | $63.10 | $81.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $43.65 | Professional | None | $38.90 | $38.90 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $60.26 Typical High $79.43 | Facility | None | $52.48 | $60.26 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medcost Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $44.67 | Facility | None | $32.36 | $32.36 | $44.67 |
Medcost Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $43.65 | Professional | None | $28.18 | $28.18 | $43.65 |
United Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $38.90 | Professional | None | $37.15 | $38.90 | $38.90 |
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 $16.22 Median $16.22 Typical High $19.50 | Professional | 52 · Reduced service | $16.22 | $16.22 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $7.76 | Professional | 53 · Discontinued | $6.46 | $6.46 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $5.75 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.89 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $34.67 Median $34.67 Typical High $37.15 | Professional | JW · Drug discarded | $34.67 | $34.67 | $37.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 51 · Multiple procedures | $14.13 | $14.13 | $14.13 |
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· 12th of 51
$38.90
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.