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 $28.84 Median $28.84 Typical High $79.43 | Facility | None | $28.84 | $28.84 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $28.84 Typical High $29.51 | Professional | None | $24.55 | $28.84 | $29.51 |
Ambetter Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
BCBS North Carolina Setting Facility Modifier None Typical Low $21.38 Median $31.62 Typical High $42.66 | Facility | None | $21.38 | $31.62 | $42.66 |
BCBS North Carolina Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $37.15 | Professional | None | $20.42 | $20.42 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $37.15 Typical High $52.48 | Facility | None | $34.67 | $37.15 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Medcost Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $29.51 | Facility | None | $28.84 | $28.84 | $29.51 |
Medcost Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | None | $69.18 | $69.18 | $83.18 |
United Setting Professional Modifier None Typical Low $23.99 Median $25.12 Typical High $26.30 | Professional | None | $23.99 | $25.12 | $26.30 |
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 $12.30 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $12.30 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $4.90 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $3.72 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.45 | $2.88 | $2.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $11.22 Median $34.67 Typical High $34.67 | Professional | 51 · Multiple procedures | $11.22 | $34.67 | $34.67 |
Where North Carolina sits
The same service costs 2.8 times more in Wyoming 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
$22.39
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.