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 $29.51 Median $29.51 Typical High $120.23 | Facility | None | $29.51 | $29.51 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $57.54 | Professional | None | $29.51 | $29.51 | $57.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $120.23 | Facility | None | $66.07 | $104.71 | $120.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $87.10 | Professional | None | $56.23 | $56.23 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $89.13 Typical High $123.03 | Facility | None | $77.62 | $89.13 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Medcost Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $66.07 | Facility | None | $29.51 | $29.51 | $66.07 |
Medcost Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $87.10 | Professional | None | $36.31 | $36.31 | $87.10 |
United Setting Professional Modifier None Typical Low $56.23 Median $58.88 Typical High $61.66 | Professional | None | $56.23 | $58.88 | $61.66 |
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 $14.79 Median $14.79 Typical High $28.18 | Professional | 52 · Reduced service | $14.79 | $14.79 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $11.22 | Professional | 53 · Discontinued | $5.89 | $5.89 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $8.51 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $5.62 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $5.62 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.88 Median $18.20 Typical High $18.20 | Professional | 51 · Multiple procedures | $12.88 | $18.20 | $18.20 |
Where North Carolina sits
Rates are fairly even across states for this service. 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· 24th of 51
$56.23
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.