How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $42.66 | Facility | None | $36.31 | $36.31 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
BCBS North Carolina Setting Professional Modifier None Typical Low $58.88 Median $60.26 Typical High $117.49 | Professional | None | $58.88 | $60.26 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Medcost Setting Facility Modifier None Typical Low $64.57 Median $69.18 Typical High $104.71 | Facility | None | $64.57 | $69.18 | $104.71 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $2,454.71 | Professional | None | $1,000.00 | $1,000.00 | $2,454.71 |
4 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 $18.20 | Professional | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
Where North Carolina sits
The same service costs 35.5 times more in Texas than in Kentucky. 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· 42nd of 51
$60.26
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.