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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,513.56 | $1,513.56 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,698.24 | Facility | None | $1,412.54 | $1,412.54 | $1,698.24 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,380.38 | $1,737.80 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,513.56 | Professional | None | $758.58 | $758.58 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,089.30 | Facility | None | $1,513.56 | $1,513.56 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $1,288.25 | Professional | None | $1,148.15 | $1,202.26 | $1,288.25 |
United Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $870.96 | Professional | None | $512.86 | $660.69 | $870.96 |
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 $602.56 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $602.56 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $239.88 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $177.83 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $120.23 | $151.36 | $151.36 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $602.56 Typical High $645.65 | Professional | 51 · Multiple procedures | $575.44 | $602.56 | $645.65 |
Where North Carolina sits
The same service costs 2.7 times more in Montana than in New Jersey. 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· 10th of 51
$1,585
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.