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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | None | $114.82 | $125.89 | $125.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $275.42 | Facility | None | $229.09 | $229.09 | $275.42 |
BCBS North Carolina Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $144.54 | Professional | None | $114.82 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Facility | None | $125.89 | $125.89 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $112.20 | Professional | None | $95.50 | $112.20 | $112.20 |
United Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $81.28 | Professional | None | $40.74 | $57.54 | $81.28 |
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 $57.54 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $57.54 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $22.91 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $16.98 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.48 | $12.59 | $12.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $47.86 Median $56.23 Typical High $56.23 | Professional | 51 · Multiple procedures | $47.86 | $56.23 | $56.23 |
Where North Carolina sits
The same service costs 3.0 times more in California than in New York. 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· 7th of 51
$132
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.