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 $46.77 Median $46.77 Typical High $114.82 | Facility | None | $46.77 | $46.77 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $46.77 Typical High $46.77 | Professional | None | $31.62 | $46.77 | $46.77 |
Ambetter Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
BCBS North Carolina Setting Facility Modifier None Typical Low $35.48 Median $46.77 Typical High $66.07 | Facility | None | $35.48 | $46.77 | $66.07 |
BCBS North Carolina Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $63.10 | Professional | None | $33.88 | $33.88 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $51.29 Typical High $67.61 | Facility | None | $44.67 | $51.29 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Medcost Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $46.77 | Facility | None | $38.02 | $38.02 | $46.77 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $100.00 | Professional | None | $75.86 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $35.48 Median $38.02 Typical High $39.81 | Professional | None | $35.48 | $38.02 | $39.81 |
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 $15.85 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $15.85 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $6.46 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $4.79 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.24 | $4.68 | $4.68 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.79 Median $50.12 Typical High $50.12 | Professional | 51 · Multiple procedures | $14.79 | $50.12 | $50.12 |
Where North Carolina sits
The same service costs 1.7 times more in Hawaii 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· 29th of 51
$33.88
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.