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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | None | $245.47 | $245.47 | $288.40 |
BCBS North Carolina Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $223.87 | Professional | None | $60.26 | $75.86 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $257.04 Typical High $389.05 | Facility | None | $245.47 | $257.04 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
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 $120.23 Median $120.23 Typical High $144.54 | Professional | 52 · Reduced service | $120.23 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $58.88 | Professional | 53 · Discontinued | $48.98 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $43.65 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $28.84 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $28.84 |
Where North Carolina sits
The same service costs 25.1 times more in North Dakota than in West Virginia. 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· 37th of 51
$75.86
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.