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 $141.25 Median $141.25 Typical High $426.58 | Facility | None | $141.25 | $141.25 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $154.88 | Professional | None | $141.25 | $141.25 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
BCBS North Carolina Setting Facility Modifier None Typical Low $165.96 Median $223.87 Typical High $281.84 | Facility | None | $165.96 | $223.87 | $281.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $354.81 | Professional | None | $144.54 | $158.49 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $239.88 Typical High $338.84 | Facility | None | $208.93 | $239.88 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $177.83 | Facility | None | $141.25 | $141.25 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $416.87 | Professional | None | $398.11 | $398.11 | $416.87 |
United Setting Professional Modifier None Typical Low $134.90 Median $144.54 Typical High $151.36 | Professional | None | $134.90 | $144.54 | $151.36 |
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 $70.79 Median $70.79 Typical High $77.62 | Professional | 52 · Reduced service | $70.79 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $30.90 | Professional | 53 · Discontinued | $28.18 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $22.91 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $15.49 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $15.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $47.86 Median $199.53 Typical High $199.53 | Professional | 51 · Multiple procedures | $47.86 | $199.53 | $199.53 |
Where North Carolina sits
The same service costs 2.4 times more in Wyoming 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· 46th of 51
$148
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.