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 $36.31 Median $36.31 Typical High $66.07 | Facility | None | $36.31 | $36.31 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $45.71 | Professional | None | $36.31 | $36.31 | $45.71 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $46.77 Median $69.18 Typical High $93.33 | Facility | None | $46.77 | $69.18 | $93.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $48.98 | Professional | None | $30.20 | $44.67 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $70.79 Typical High $97.72 | Facility | None | $61.66 | $70.79 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Medcost Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $52.48 | Facility | None | $36.31 | $36.31 | $52.48 |
Medcost Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $50.12 | Professional | None | $28.84 | $28.84 | $50.12 |
United Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $44.67 | Professional | None | $42.66 | $44.67 | $44.67 |
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 $18.20 Median $18.20 Typical High $22.39 | Professional | 52 · Reduced service | $18.20 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $8.91 | Professional | 53 · Discontinued | $7.24 | $7.24 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $6.76 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $4.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 51 · Multiple procedures | $14.45 | $14.45 | $14.45 |
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· 15th of 51
$44.67
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.