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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $38.02 Typical High $38.02 | Professional | None | $30.90 | $38.02 | $38.02 |
BCBS North Carolina Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $85.11 | Facility | None | $70.79 | $70.79 | $85.11 |
BCBS North Carolina Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $35.48 | Professional | None | $32.36 | $33.88 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Medcost Setting Facility Modifier None Typical Low $38.02 Median $53.70 Typical High $147.91 | Facility | None | $38.02 | $53.70 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $39.81 Median $44.67 Typical High $74.13 | Professional | None | $39.81 | $44.67 | $74.13 |
United Setting Professional Modifier None Typical Low $15.49 Median $20.89 Typical High $23.99 | Professional | None | $15.49 | $20.89 | $23.99 |
6 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 $15.14 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $15.14 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $7.76 Typical High $7.76 | Professional | 53 · Discontinued | $6.17 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $28.84 Typical High $28.84 | Professional | 54 · Surgery only | $22.91 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $4.57 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.09 | $3.80 | $3.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.95 Median $22.39 Typical High $52.48 | Professional | 51 · Multiple procedures | $19.95 | $22.39 | $52.48 |
Where North Carolina sits
The same service costs 2.7 times more in Hawaii than in New York. 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· 19th of 51
$33.88
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.