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 $26.30 Median $31.62 Typical High $31.62 | Facility | None | $26.30 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $33.88 | Professional | None | $31.62 | $31.62 | $33.88 |
BCBS North Carolina Setting Facility Modifier None Typical Low $40.74 Median $57.54 Typical High $67.61 | Facility | None | $40.74 | $57.54 | $67.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $38.02 | Professional | None | $34.67 | $34.67 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $48.98 Typical High $72.44 | Facility | None | $37.15 | $48.98 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Medcost Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $38.90 | Facility | None | $31.62 | $31.62 | $38.90 |
Medcost Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $38.02 | Professional | None | $25.70 | $25.70 | $38.02 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
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 $15.85 Median $15.85 Typical High $16.60 | Professional | 52 · Reduced service | $15.85 | $15.85 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.76 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $5.01 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.39 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.88 Median $12.88 Typical High $15.14 | Professional | 51 · Multiple procedures | $12.88 | $12.88 | $15.14 |
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· 9th of 51
$34.67
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.