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 $25.70 Median $25.70 Typical High $112.20 | Facility | None | $25.70 | $25.70 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $63.10 | Professional | None | $25.70 | $25.70 | $63.10 |
BCBS North Carolina Setting Facility Modifier None Typical Low $66.07 Median $89.13 Typical High $112.20 | Facility | None | $66.07 | $89.13 | $112.20 |
BCBS North Carolina Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $93.33 | Professional | None | $57.54 | $57.54 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $91.20 Typical High $128.82 | Facility | None | $70.79 | $91.20 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Medcost Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $72.44 | Facility | None | $25.70 | $25.70 | $72.44 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | None | $91.20 | $91.20 | $109.65 |
United Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $63.10 | Professional | None | $56.23 | $60.26 | $63.10 |
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 $12.88 Median $12.88 Typical High $30.90 | Professional | 52 · Reduced service | $12.88 | $12.88 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $12.59 | Professional | 53 · Discontinued | $5.25 | $5.25 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $9.33 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $6.17 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $6.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $11.75 Median $45.71 Typical High $45.71 | Professional | 51 · Multiple procedures | $11.75 | $45.71 | $45.71 |
Where North Carolina sits
The same service costs 2.0 times more in Wyoming than in Hawaii. 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· 49th of 51
$57.54
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.