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 $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $19.50 Typical High $19.50 | Professional | None | $14.79 | $19.50 | $19.50 |
BCBS North Carolina Setting Professional Modifier None Typical Low $17.78 Median $22.39 Typical High $22.39 | Professional | None | $17.78 | $22.39 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $15.14 | Professional | None | $9.77 | $9.77 | $15.14 |
Medcost Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $26.92 | Facility | None | $19.50 | $19.50 | $26.92 |
Medcost Setting Professional Modifier None Typical Low $14.79 Median $15.85 Typical High $16.60 | Professional | None | $14.79 | $15.85 | $16.60 |
United Setting Professional Modifier None Typical Low $6.03 Median $7.76 Typical High $11.48 | Professional | None | $6.03 | $7.76 | $11.48 |
6 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 $7.76 Median $9.77 Typical High $9.77 | Professional | 52 · Reduced service | $7.76 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.89 Typical High $3.89 | Professional | 53 · Discontinued | $3.09 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $2.29 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.95 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.55 | $1.95 | $1.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $7.41 Median $7.94 Typical High $8.32 | Professional | 51 · Multiple procedures | $7.41 | $7.94 | $8.32 |
Oscar Health Setting Professional Modifier BS Typical Low $7.08 Median $7.08 Typical High $15.14 | Professional | BS | $7.08 | $7.08 | $15.14 |
Where North Carolina sits
The same service costs 3.2 times more in Montana 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· 6th of 51
$20.42
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.