How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $128.82 Median $162.18 Typical High $218.78 | Facility | None | $128.82 | $162.18 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $190.55 | Professional | None | $128.82 | $162.18 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $257.04 | Professional | None | $131.83 | $181.97 | $257.04 |
BCBS North Carolina Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $223.87 | Professional | None | $131.83 | $173.78 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $190.55 | Professional | None | $60.26 | $60.26 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $190.55 | Facility | None | $154.88 | $154.88 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $158.49 | Professional | None | $109.65 | $131.83 | $158.49 |
Oscar Health Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
Oscar Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $186.21 | Professional | None | $141.25 | $141.25 | $186.21 |
United Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $186.21 | Professional | None | $141.25 | $141.25 | $186.21 |
9 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 Facility Modifier AF · Specialist physician Typical Low $169.82 Median $190.55 Typical High $190.55 | Facility | AF · Specialist physician | $169.82 | $190.55 | $190.55 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $125.89 Median $144.54 Typical High $144.54 | Facility | HO · Master's level | $125.89 | $144.54 | $144.54 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $141.25 Median $162.18 Typical High $162.18 | Facility | TD · Registered nurse | $141.25 | $162.18 | $162.18 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $141.25 Median $181.97 Typical High $190.55 | Professional | AF · Specialist physician | $141.25 | $181.97 | $190.55 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $125.89 Median $144.54 Typical High $144.54 | Professional | HO · Master's level | $125.89 | $144.54 | $144.54 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $75.86 Median $154.88 Typical High $162.18 | Professional | TD · Registered nurse | $75.86 | $154.88 | $162.18 |
Ambetter Setting Professional Modifier HI · Mental health + developmental disability Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | HI · Mental health + developmental disability | $165.96 | $165.96 | $165.96 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $125.89 Median $147.91 Typical High $194.98 | Professional | SA · Nurse practitioner | $125.89 | $147.91 | $194.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $54.95 Median $66.07 Typical High $79.43 | Professional | 51 · Multiple procedures | $54.95 | $66.07 | $79.43 |
Where North Carolina sits
The same service costs 2.2 times more in North Dakota than in Kentucky. 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
$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.