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 $141.25 Median $141.25 Typical High $169.82 | Facility | None | $141.25 | $141.25 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $199.53 | Professional | None | $141.25 | $141.25 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $190.55 | Professional | None | $120.23 | $169.82 | $190.55 |
BCBS North Carolina Setting Facility Modifier None Typical Low $316.23 Median $363.08 Typical High $457.09 | Facility | None | $316.23 | $363.08 | $457.09 |
BCBS North Carolina Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $457.09 | Professional | None | $144.54 | $251.19 | $457.09 |
BCBS North Carolina Setting Professional Modifier QW · Waived lab test Typical Low $131.83 Median $141.25 Typical High $181.97 | Professional | QW · Waived lab test | $131.83 | $141.25 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $436.52 Typical High $645.65 | Facility | None | $208.93 | $436.52 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $117.49 Typical High $218.78 | Professional | None | $70.79 | $117.49 | $218.78 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $169.82 | Facility | None | $141.25 | $141.25 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $245.47 | Professional | None | $141.25 | $141.25 | $245.47 |
United Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $165.96 | Professional | None | $60.26 | $95.50 | $165.96 |
3 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 $70.79 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $70.79 Median $70.79 Typical High $181.97 | Professional | 51 · Multiple procedures | $70.79 | $70.79 | $181.97 |
Where North Carolina sits
The same service costs 4.3 times more in Alaska than in Alabama. 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· 14th of 51
$166
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.