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 $79.43 Median $79.43 Typical High $112.20 | Facility | None | $79.43 | $79.43 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $125.89 | Professional | None | $79.43 | $104.71 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $158.49 | Professional | None | $102.33 | $102.33 | $158.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $269.15 | Professional | None | $107.15 | $173.78 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $162.18 | Professional | None | $75.86 | $112.20 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $154.88 | Professional | None | $104.71 | $128.82 | $154.88 |
Medcost Setting Facility Modifier None Typical Low $79.43 Median $112.20 Typical High $134.90 | Facility | None | $79.43 | $112.20 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $138.04 | Professional | None | $87.10 | $107.15 | $138.04 |
Oscar Health Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $251.19 | Professional | None | $123.03 | $154.88 | $251.19 |
United Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $154.88 | Professional | None | $63.10 | $93.33 | $154.88 |
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 $38.90 Median $42.66 Typical High $54.95 | Professional | 52 · Reduced service | $38.90 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.88 Typical High $16.60 | Professional | 55 · Aftercare only | $11.75 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.51 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.94 | $8.51 | $11.22 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $95.50 Median $112.20 Typical High $158.49 | Professional | 25 · Same-day visit | $95.50 | $112.20 | $158.49 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | EP · Child screening program | $112.20 | $112.20 | $112.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $43.65 Median $53.70 Typical High $72.44 | Professional | 51 · Multiple procedures | $43.65 | $53.70 | $72.44 |
Where North Carolina sits
The same service costs 2.8 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· 4th 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.