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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $69.18 | Professional | None | $53.70 | $69.18 | $69.18 |
BCBS Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $79.43 | Professional | None | $63.10 | $79.43 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Medcost Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $95.50 | Facility | None | $69.18 | $69.18 | $95.50 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $58.88 | Professional | None | $52.48 | $57.54 | $58.88 |
United Setting Professional Modifier None Typical Low $19.05 Median $26.92 Typical High $39.81 | Professional | None | $19.05 | $26.92 | $39.81 |
7 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 $27.54 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $27.54 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $10.96 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $8.13 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.50 | $6.92 | $6.92 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.30 Median $28.84 Typical High $29.51 | Professional | 51 · Multiple procedures | $26.30 | $28.84 | $29.51 |
Oscar Health Setting Professional Modifier MV Typical Low $25.12 Median $25.12 Typical High $54.95 | Professional | MV | $25.12 | $25.12 | $54.95 |
Oscar Health Setting Professional Modifier SV · Delivered, not used Typical Low $25.12 Median $25.12 Typical High $54.95 | Professional | SV · Delivered, not used | $25.12 | $25.12 | $54.95 |
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· 3rd of 51
$72.44
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.