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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $31.62 Typical High $52.48 | Professional | None | $26.30 | $31.62 | $52.48 |
Ambetter Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
BCBS North Carolina Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $70.79 | Facility | None | $58.88 | $58.88 | $70.79 |
BCBS North Carolina Setting Professional Modifier None Typical Low $23.99 Median $28.18 Typical High $29.51 | Professional | None | $23.99 | $28.18 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Medcost Setting Facility Modifier None Typical Low $31.62 Median $44.67 Typical High $173.78 | Facility | None | $31.62 | $44.67 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $32.36 Median $46.77 Typical High $61.66 | Professional | None | $32.36 | $46.77 | $61.66 |
United Setting Professional Modifier None Typical Low $12.88 Median $17.38 Typical High $19.95 | Professional | None | $12.88 | $17.38 | $19.95 |
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 $12.59 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $12.59 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $5.13 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $23.99 Typical High $23.99 | Professional | 54 · Surgery only | $19.05 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $3.80 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.51 | $3.16 | $3.16 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.85 Median $23.44 Typical High $43.65 | Professional | 51 · Multiple procedures | $15.85 | $23.44 | $43.65 |
Where North Carolina sits
The same service costs 3.1 times more in Rhode Island 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· 24th of 51
$28.18
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.