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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $36.31 Typical High $36.31 | Professional | None | $25.70 | $36.31 | $36.31 |
BCBS North Carolina Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $81.28 | Facility | None | $67.61 | $67.61 | $81.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $27.54 Median $32.36 Typical High $33.88 | Professional | None | $27.54 | $32.36 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Medcost Setting Facility Modifier None Typical Low $36.31 Median $51.29 Typical High $102.33 | Facility | None | $36.31 | $51.29 | $102.33 |
Medcost Setting Professional Modifier None Typical Low $27.54 Median $30.90 Typical High $70.79 | Professional | None | $27.54 | $30.90 | $70.79 |
United Setting Professional Modifier None Typical Low $14.79 Median $19.95 Typical High $22.91 | Professional | None | $14.79 | $19.95 | $22.91 |
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 $14.13 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $14.13 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $5.62 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $27.54 Typical High $27.54 | Professional | 54 · Surgery only | $21.38 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $4.27 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.82 | $3.63 | $3.63 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $13.80 Median $15.49 Typical High $50.12 | Professional | 51 · Multiple procedures | $13.80 | $15.49 | $50.12 |
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
$32.36
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.