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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | None | $50.12 | $64.57 | $64.57 |
BCBS North Carolina Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $60.26 | Professional | None | $48.98 | $56.23 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Medcost Setting Facility Modifier None Typical Low $64.57 Median $89.13 Typical High $245.47 | Facility | None | $64.57 | $89.13 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $48.98 Median $72.44 Typical High $123.03 | Professional | None | $48.98 | $72.44 | $123.03 |
United Setting Professional Modifier None Typical Low $26.30 Median $35.48 Typical High $40.74 | Professional | None | $26.30 | $35.48 | $40.74 |
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 $25.12 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $25.12 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $10.00 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $48.98 Typical High $48.98 | Professional | 54 · Surgery only | $37.15 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $7.41 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.01 | $6.46 | $6.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $24.55 Median $37.15 Typical High $87.10 | Professional | 51 · Multiple procedures | $24.55 | $37.15 | $87.10 |
Where North Carolina sits
The same service costs 2.8 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· 20th of 51
$56.23
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.