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 $57.54 Median $61.66 Typical High $61.66 | Facility | None | $57.54 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $61.66 Typical High $61.66 | Professional | None | $58.88 | $61.66 | $61.66 |
BCBS Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $100.00 | Professional | None | $63.10 | $69.18 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $77.62 Typical High $131.83 | Facility | None | $69.18 | $77.62 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Medcost Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $64.57 | Facility | None | $61.66 | $61.66 | $64.57 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $72.44 Typical High $75.86 | Professional | None | $50.12 | $72.44 | $75.86 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $29.51 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $29.51 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $11.75 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.89 | $6.17 | $6.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $18.62 Median $31.62 Typical High $38.02 | Professional | 51 · Multiple procedures | $18.62 | $31.62 | $38.02 |
Where North Carolina sits
The same service costs 1.6 times more in Alaska than in Hawaii. 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· 7th of 51
$63.10
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.