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 $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $9.77 Median $12.88 Typical High $12.88 | Professional | None | $9.77 | $12.88 | $12.88 |
BCBS North Carolina Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $14.79 | Facility | None | $12.30 | $12.30 | $14.79 |
BCBS North Carolina Setting Professional Modifier None Typical Low $12.02 Median $15.14 Typical High $15.14 | Professional | None | $12.02 | $15.14 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Medcost Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $18.20 | Facility | None | $12.88 | $12.88 | $18.20 |
Medcost Setting Professional Modifier None Typical Low $10.00 Median $10.96 Typical High $11.22 | Professional | None | $10.00 | $10.96 | $11.22 |
United Setting Professional Modifier None Typical Low $4.07 Median $5.13 Typical High $7.41 | Professional | None | $4.07 | $5.13 | $7.41 |
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 $5.01 Median $6.46 Typical High $6.46 | Professional | 52 · Reduced service | $5.01 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.63 Typical High $2.63 | Professional | 53 · Discontinued | $2.00 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.48 Median $1.95 Typical High $1.95 | Professional | 55 · Aftercare only | $1.48 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.29 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.00 | $1.29 | $1.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.01 Median $5.50 Typical High $5.62 | Professional | 51 · Multiple procedures | $5.01 | $5.50 | $5.62 |
Where North Carolina sits
The same service costs 2.7 times more in Montana than in Utah. 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· 3rd of 51
$13.80
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.