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 $74.13 Median $74.13 Typical High $107.15 | Facility | None | $74.13 | $74.13 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $120.23 | Professional | None | $74.13 | $100.00 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $151.36 | Professional | None | $91.20 | $125.89 | $151.36 |
BCBS North Carolina Setting Professional Modifier None Typical Low $93.33 Median $169.82 Typical High $257.04 | Professional | None | $93.33 | $169.82 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $104.71 Typical High $154.88 | Professional | None | $67.61 | $104.71 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $144.54 | Professional | None | $95.50 | $120.23 | $144.54 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $107.15 Typical High $128.82 | Facility | None | $74.13 | $107.15 | $128.82 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $125.89 | Professional | None | $85.11 | $97.72 | $125.89 |
Oscar Health Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $239.88 | Professional | None | $114.82 | $144.54 | $239.88 |
United Setting Professional Modifier None Typical Low $56.23 Median $85.11 Typical High $144.54 | Professional | None | $56.23 | $85.11 | $144.54 |
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 $37.15 Median $39.81 Typical High $53.70 | Professional | 52 · Reduced service | $37.15 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.02 Typical High $15.85 | Professional | 55 · Aftercare only | $10.96 | $12.02 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.94 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.41 | $7.94 | $10.72 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $91.20 Median $109.65 Typical High $151.36 | Professional | 25 · Same-day visit | $91.20 | $109.65 | $151.36 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $109.65 Median $109.65 Typical High $158.49 | Professional | EP · Child screening program | $109.65 | $109.65 | $158.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $41.69 Median $48.98 Typical High $66.07 | Professional | 51 · Multiple procedures | $41.69 | $48.98 | $66.07 |
Where North Carolina sits
The same service costs 2.9 times more in Alaska than in Washington, DC. 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
$155
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.