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 $93.33 Median $95.50 Typical High $275.42 | Facility | None | $93.33 | $95.50 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $181.97 | Professional | None | $93.33 | $93.33 | $181.97 |
BCBS North Carolina Setting Facility Modifier None Typical Low $257.04 Median $316.23 Typical High $512.86 | Facility | None | $257.04 | $316.23 | $512.86 |
BCBS North Carolina Setting Professional Modifier None Typical Low $87.10 Median $177.83 Typical High $457.09 | Professional | None | $87.10 | $177.83 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $257.04 Typical High $524.81 | Facility | None | $95.50 | $257.04 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $158.49 Typical High $281.84 | Professional | None | $54.95 | $158.49 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $138.04 | Facility | None | $93.33 | $93.33 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $263.03 | Professional | None | $165.96 | $213.80 | $263.03 |
United Setting Professional Modifier None Typical Low $69.18 Median $109.65 Typical High $245.47 | Professional | None | $69.18 | $109.65 | $245.47 |
4 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 $45.71 Median $46.77 Typical High $70.79 | Professional | 52 · Reduced service | $45.71 | $46.77 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.62 Typical High $28.18 | Professional | 53 · Discontinued | $18.20 | $18.62 | $28.18 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 90 · Outside lab | $165.96 | $165.96 | $165.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $107.15 Typical High $162.18 | Professional | 51 · Multiple procedures | $83.18 | $107.15 | $162.18 |
Where North Carolina sits
The same service costs 6.3 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· 20th of 51
$162
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.