How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | None | $85.11 | $93.33 | $93.33 |
BCBS North Carolina Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $107.15 | Facility | None | $89.13 | $89.13 | $107.15 |
BCBS North Carolina Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $109.65 | Professional | None | $87.10 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $81.28 | Professional | None | $52.48 | $52.48 | $81.28 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $131.83 | Facility | None | $93.33 | $93.33 | $131.83 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $81.28 | Professional | None | $72.44 | $75.86 | $81.28 |
United Setting Professional Modifier None Typical Low $35.48 Median $41.69 Typical High $53.70 | Professional | None | $35.48 | $41.69 | $53.70 |
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 $42.66 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $42.66 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $16.98 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $12.88 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $9.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $35.48 Median $38.02 Typical High $40.74 | Professional | 51 · Multiple procedures | $35.48 | $38.02 | $40.74 |
Where North Carolina sits
The same service costs 3.2 times more in Hawaii than in Arizona. 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· 15th of 51
$100
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.