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 $25.70 Median $25.70 Typical High $64.57 | Facility | None | $25.70 | $25.70 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
BCBS North Carolina Setting Facility Modifier None Typical Low $38.90 Median $60.26 Typical High $69.18 | Facility | None | $38.90 | $60.26 | $69.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $38.90 | Professional | None | $33.11 | $33.11 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $52.48 Typical High $74.13 | Facility | None | $46.77 | $52.48 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Medcost Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $38.90 | Facility | None | $25.70 | $25.70 | $38.90 |
Medcost Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $38.90 | Professional | None | $25.70 | $25.70 | $38.90 |
United Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $33.11 | Professional | None | $30.90 | $33.11 | $33.11 |
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 $12.88 Median $12.88 Typical High $16.98 | Professional | 52 · Reduced service | $12.88 | $12.88 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $6.76 | Professional | 53 · Discontinued | $5.13 | $5.13 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $5.13 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $3.39 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $33.11 Median $33.11 Typical High $37.15 | Professional | JW · Drug discarded | $33.11 | $33.11 | $37.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 51 · Multiple procedures | $12.88 | $12.88 | $12.88 |
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· 40th of 51
$33.11
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.