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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $37.15 Typical High $37.15 | Professional | None | $26.92 | $37.15 | $37.15 |
BCBS North Carolina Setting Professional Modifier None Typical Low $28.18 Median $32.36 Typical High $34.67 | Professional | None | $28.18 | $32.36 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Medcost Setting Facility Modifier None Typical Low $37.15 Median $51.29 Typical High $158.49 | Facility | None | $37.15 | $51.29 | $158.49 |
Medcost Setting Professional Modifier None Typical Low $38.02 Median $42.66 Typical High $91.20 | Professional | None | $38.02 | $42.66 | $91.20 |
United Setting Professional Modifier None Typical Low $15.14 Median $20.42 Typical High $23.44 | Professional | None | $15.14 | $20.42 | $23.44 |
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 $14.45 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $14.45 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $5.75 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $28.18 Typical High $28.18 | Professional | 54 · Surgery only | $21.38 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $4.37 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.88 | $3.72 | $3.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.05 Median $21.38 Typical High $50.12 | Professional | 51 · Multiple procedures | $19.05 | $21.38 | $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· 21st 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.