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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $50.12 Typical High $50.12 | Professional | None | $20.89 | $50.12 | $50.12 |
BCBS North Carolina Setting Facility Modifier None Typical Low $28.84 Median $41.69 Typical High $57.54 | Facility | None | $28.84 | $41.69 | $57.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $50.12 | Professional | None | $26.92 | $26.92 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $29.51 Median $33.88 Typical High $46.77 | Facility | None | $29.51 | $33.88 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Medcost Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $50.12 | Facility | None | $25.12 | $25.12 | $50.12 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $107.15 | Professional | None | $58.88 | $58.88 | $107.15 |
United Setting Professional Modifier None Typical Low $29.51 Median $31.62 Typical High $33.11 | Professional | None | $29.51 | $31.62 | $33.11 |
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 $10.47 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $10.47 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $4.17 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $3.16 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $2.09 | $5.01 | $5.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $20.42 Median $28.84 Typical High $28.84 | Professional | 51 · Multiple procedures | $20.42 | $28.84 | $28.84 |
Where North Carolina sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 19th of 51
$26.92
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.