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 $30.90 Median $30.90 Typical High $109.65 | Facility | None | $30.90 | $30.90 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $30.90 Typical High $30.90 | Professional | None | $25.70 | $30.90 | $30.90 |
Ambetter Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
BCBS North Carolina Setting Facility Modifier None Typical Low $23.99 Median $35.48 Typical High $47.86 | Facility | None | $23.99 | $35.48 | $47.86 |
BCBS North Carolina Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $41.69 | Professional | None | $22.91 | $22.91 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $38.90 Typical High $54.95 | Facility | None | $36.31 | $38.90 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Medcost Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Medcost Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $74.13 | Professional | None | $33.88 | $33.88 | $74.13 |
United Setting Professional Modifier None Typical Low $25.70 Median $27.54 Typical High $28.84 | Professional | None | $25.70 | $27.54 | $28.84 |
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 $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $12.88 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $5.13 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $3.89 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.57 | $3.09 | $3.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $11.75 Median $16.98 Typical High $16.98 | Professional | 51 · Multiple procedures | $11.75 | $16.98 | $16.98 |
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· 51st of 51
$25.12
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.