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 $0.78 Median $0.78 Typical High $0.78 | Facility | None | $0.78 | $0.78 | $0.78 |
Aetna Setting Professional Modifier None Typical Low $0.78 Median $0.78 Typical High $1.95 | Professional | None | $0.78 | $0.78 | $1.95 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1.66 Median $2.24 Typical High $4.07 | Professional | None | $1.66 | $2.24 | $4.07 |
Cigna Setting Facility Modifier None Typical Low $2.09 Median $2.82 Typical High $3.98 | Facility | None | $2.09 | $2.82 | $3.98 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Medcost Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Medcost Setting Facility Modifier None Typical Low $0.78 Median $0.78 Typical High $2.24 | Facility | None | $0.78 | $0.78 | $2.24 |
Medcost Setting Professional Modifier None Typical Low $2.24 Median $5.25 Typical High $6.76 | Professional | None | $2.24 | $5.25 | $6.76 |
United Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | None | $1.66 | $1.66 | $1.66 |
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 $0.39 Median $0.39 Typical High $0.98 | Professional | 52 · Reduced service | $0.39 | $0.39 | $0.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.39 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.28 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.28 Median $2.63 Typical High $3.39 | Professional | 51 · Multiple procedures | $0.28 | $2.63 | $3.39 |
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· 13th of 51
$1.86
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.