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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $74.13 | Professional | None | $53.70 | $74.13 | $74.13 |
BCBS North Carolina Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $162.18 | Facility | None | $134.90 | $134.90 | $162.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $54.95 Median $64.57 Typical High $67.61 | Professional | None | $54.95 | $64.57 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $102.33 Typical High $204.17 | Facility | None | $74.13 | $102.33 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $141.25 | Professional | None | $54.95 | $61.66 | $141.25 |
United Setting Professional Modifier None Typical Low $29.51 Median $40.74 Typical High $45.71 | Professional | None | $29.51 | $40.74 | $45.71 |
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 $28.18 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $28.18 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $11.22 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $54.95 Typical High $54.95 | Professional | 54 · Surgery only | $42.66 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $8.51 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.62 | $7.41 | $7.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $27.54 Median $30.90 Typical High $100.00 | Professional | 51 · Multiple procedures | $27.54 | $30.90 | $100.00 |
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
$64.57
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.