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 $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $29.51 Typical High $29.51 | Professional | None | $22.91 | $29.51 | $29.51 |
BCBS North Carolina Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $64.57 | Facility | None | $53.70 | $53.70 | $64.57 |
BCBS North Carolina Setting Professional Modifier None Typical Low $21.88 Median $25.70 Typical High $27.54 | Professional | None | $21.88 | $25.70 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Medcost Setting Facility Modifier None Typical Low $29.51 Median $40.74 Typical High $97.72 | Facility | None | $29.51 | $40.74 | $97.72 |
Medcost Setting Professional Modifier None Typical Low $26.30 Median $29.51 Typical High $63.10 | Professional | None | $26.30 | $29.51 | $63.10 |
United Setting Professional Modifier None Typical Low $12.02 Median $16.22 Typical High $18.62 | Professional | None | $12.02 | $16.22 | $18.62 |
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 $11.48 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $11.48 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $4.57 | $5.89 | $5.89 |
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 $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $3.39 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.29 | $2.95 | $2.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.88 Median $14.79 Typical High $39.81 | Professional | 51 · Multiple procedures | $12.88 | $14.79 | $39.81 |
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
$25.70
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.