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 $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $20.89 Typical High $20.89 | Professional | None | $16.60 | $20.89 | $20.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $15.49 Median $18.20 Typical High $19.05 | Professional | None | $15.49 | $18.20 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medcost Setting Facility Modifier None Typical Low $20.89 Median $28.84 Typical High $114.82 | Facility | None | $20.89 | $28.84 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $16.98 Median $30.90 Typical High $39.81 | Professional | None | $16.98 | $30.90 | $39.81 |
United Setting Professional Modifier None Typical Low $8.32 Median $11.48 Typical High $12.88 | Professional | None | $8.32 | $11.48 | $12.88 |
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 $8.13 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $8.13 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $4.17 Typical High $4.17 | Professional | 53 · Discontinued | $3.31 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.30 Median $15.49 Typical High $15.49 | Professional | 54 · Surgery only | $12.30 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $2.45 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.62 | $2.04 | $2.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $8.32 Median $15.49 Typical High $28.18 | Professional | 51 · Multiple procedures | $8.32 | $15.49 | $28.18 |
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
$18.20
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.