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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $151.36 Typical High $151.36 | Professional | None | $147.91 | $151.36 | $151.36 |
BCBS North Carolina Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $457.09 | Professional | None | $407.38 | $426.58 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $194.98 Typical High $323.59 | Facility | None | $173.78 | $194.98 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $181.97 Typical High $245.47 | Facility | None | $151.36 | $181.97 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $213.80 | Professional | None | $169.82 | $169.82 | $213.80 |
United Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $74.13 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $74.13 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $30.20 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $22.39 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.79 | $15.14 | $15.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 51 · Multiple procedures | $85.11 | $85.11 | $85.11 |
Where North Carolina sits
The same service costs 2.2 times more in North Carolina than in Michigan. 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· 1st of 51
$324
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.