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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $446.68 Typical High $446.68 | Professional | None | $436.52 | $446.68 | $446.68 |
BCBS North Carolina Setting Professional Modifier None Typical Low $45.71 Median $53.70 Typical High $60.26 | Professional | None | $45.71 | $53.70 | $60.26 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $467.74 | Facility | None | $446.68 | $446.68 | $467.74 |
United Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $239.88 | Professional | None | $169.82 | $218.78 | $239.88 |
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 $218.78 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $87.10 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $64.57 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $43.65 | $44.67 | $44.67 |
Where North Carolina sits
The same service costs 38.0 times more in Minnesota than in Connecticut. 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· 49th 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.