How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $32.36 | Professional | None | $12.88 | $12.88 | $32.36 |
BCBS North Carolina Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $9.33 | Professional | None | $7.08 | $7.08 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $41.69 Typical High $70.79 | Facility | None | $37.15 | $41.69 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Medcost Setting Facility Modifier None Typical Low $12.88 Median $15.49 Typical High $42.66 | Facility | None | $12.88 | $15.49 | $42.66 |
Medcost Setting Professional Modifier None Typical Low $38.90 Median $45.71 Typical High $51.29 | Professional | None | $38.90 | $45.71 | $51.29 |
United Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
5 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 $6.46 Median $6.46 Typical High $16.22 | Professional | 52 · Reduced service | $6.46 | $6.46 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.57 Typical High $6.46 | Professional | 53 · Discontinued | $2.57 | $2.57 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $4.90 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $3.24 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $3.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.85 Median $22.91 Typical High $22.91 | Professional | 51 · Multiple procedures | $15.85 | $22.91 | $22.91 |
Where North Carolina sits
The same service costs 5.6 times more in Alaska than in North Carolina. 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· 51st of 51
$9.33
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.