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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $28.84 Typical High $28.84 | Professional | None | $20.42 | $28.84 | $28.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $21.88 Median $25.12 Typical High $26.92 | Professional | None | $21.88 | $25.12 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Medcost Setting Facility Modifier None Typical Low $28.84 Median $39.81 Typical High $128.82 | Facility | None | $28.84 | $39.81 | $128.82 |
Medcost Setting Professional Modifier None Typical Low $26.92 Median $33.88 Typical High $56.23 | Professional | None | $26.92 | $33.88 | $56.23 |
United Setting Professional Modifier None Typical Low $11.75 Median $15.85 Typical High $18.20 | Professional | None | $11.75 | $15.85 | $18.20 |
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 $11.22 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $11.22 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $4.47 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.98 Median $21.88 Typical High $21.88 | Professional | 54 · Surgery only | $16.98 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $3.39 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.24 | $2.88 | $2.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $13.49 Median $16.98 Typical High $39.81 | Professional | 51 · Multiple procedures | $13.49 | $16.98 | $39.81 |
Where North Carolina sits
The same service costs 2.6 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· 21st of 51
$25.12
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.