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 $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $22.39 Typical High $22.39 | Professional | None | $17.38 | $22.39 | $22.39 |
BCBS North Carolina Setting Professional Modifier None Typical Low $16.98 Median $19.50 Typical High $20.89 | Professional | None | $16.98 | $19.50 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Medcost Setting Facility Modifier None Typical Low $22.39 Median $30.90 Typical High $138.04 | Facility | None | $22.39 | $30.90 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $19.95 Median $30.20 Typical High $43.65 | Professional | None | $19.95 | $30.20 | $43.65 |
United Setting Professional Modifier None Typical Low $9.12 Median $12.30 Typical High $14.13 | Professional | None | $9.12 | $12.30 | $14.13 |
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 $8.91 Median $11.22 Typical High $11.22 | Professional | 52 · Reduced service | $8.91 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $4.47 Typical High $4.47 | Professional | 53 · Discontinued | $3.55 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.49 Median $16.98 Typical High $16.98 | Professional | 54 · Surgery only | $13.49 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $2.69 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.24 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.78 | $2.24 | $2.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $10.00 Median $18.62 Typical High $30.90 | Professional | 51 · Multiple procedures | $10.00 | $18.62 | $30.90 |
Where North Carolina sits
The same service costs 3.5 times more in Rhode Island 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· 21st of 51
$19.50
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.