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 $24.55 Median $31.62 Typical High $31.62 | Professional | None | $24.55 | $31.62 | $31.62 |
BCBS North Carolina Setting Professional Modifier None Typical Low $23.44 Median $27.54 Typical High $29.51 | Professional | None | $23.44 | $27.54 | $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 $43.65 Typical High $114.82 | Facility | None | $31.62 | $43.65 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $60.26 | Professional | None | $30.20 | $34.67 | $60.26 |
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 $12.30 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $12.30 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $4.90 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $23.44 Typical High $23.44 | Professional | 54 · Surgery only | $18.20 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $3.63 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.45 | $3.16 | $3.16 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.14 Median $16.98 Typical High $42.66 | Professional | 51 · Multiple procedures | $15.14 | $16.98 | $42.66 |
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· 19th of 51
$27.54
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.