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 $190.55 Median $190.55 Typical High $501.19 | Facility | None | $190.55 | $190.55 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $234.42 | Professional | None | $190.55 | $190.55 | $234.42 |
BCBS Setting Facility Modifier None Typical Low $288.40 Median $380.19 Typical High $489.78 | Facility | None | $288.40 | $380.19 | $489.78 |
BCBS Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | None | $234.42 | $234.42 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $363.08 Typical High $512.86 | Facility | None | $316.23 | $363.08 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $269.15 | Facility | None | $190.55 | $190.55 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $263.03 | Professional | None | $165.96 | $165.96 | $263.03 |
United Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | None | $223.87 | $234.42 | $234.42 |
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 $95.50 Median $95.50 Typical High $117.49 | Professional | 52 · Reduced service | $95.50 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $46.77 | Professional | 53 · Discontinued | $38.02 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $34.67 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $23.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 51 · Multiple procedures | $83.18 | $83.18 | $83.18 |
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
$234
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.