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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $41.69 Typical High $41.69 | Professional | None | $33.11 | $41.69 | $41.69 |
BCBS North Carolina Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $91.20 | Facility | None | $75.86 | $75.86 | $91.20 |
BCBS North Carolina Setting Professional Modifier None Typical Low $30.90 Median $36.31 Typical High $38.90 | Professional | None | $30.90 | $36.31 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Medcost Setting Facility Modifier None Typical Low $41.69 Median $57.54 Typical High $229.09 | Facility | None | $41.69 | $57.54 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $30.90 Median $61.66 Typical High $79.43 | Professional | None | $30.90 | $61.66 | $79.43 |
United Setting Professional Modifier None Typical Low $16.60 Median $22.91 Typical High $25.70 | Professional | None | $16.60 | $22.91 | $25.70 |
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 $16.60 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $16.60 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $6.61 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $30.90 Typical High $30.90 | Professional | 54 · Surgery only | $24.55 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $4.90 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.31 | $4.17 | $4.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.49 Median $30.90 Typical High $56.23 | Professional | 51 · Multiple procedures | $15.49 | $30.90 | $56.23 |
Where North Carolina sits
The same service costs 3.2 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· 20th of 51
$36.31
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.