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 $95.50 Median $95.50 Typical High $128.82 | Facility | None | $95.50 | $95.50 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $151.36 | Professional | None | $93.33 | $117.49 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $204.17 | Professional | None | $97.72 | $120.23 | $204.17 |
BCBS North Carolina Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $302.00 | Professional | None | $120.23 | $190.55 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $190.55 | Professional | None | $89.13 | $125.89 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $165.96 | Professional | None | $112.20 | $138.04 | $165.96 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $123.03 Typical High $154.88 | Facility | None | $95.50 | $123.03 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $151.36 | Professional | None | $100.00 | $117.49 | $151.36 |
Oscar Health Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $251.19 | Professional | None | $123.03 | $123.03 | $251.19 |
United Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $177.83 | Professional | None | $74.13 | $109.65 | $177.83 |
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 $46.77 Median $48.98 Typical High $63.10 | Professional | 52 · Reduced service | $46.77 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.79 Typical High $19.05 | Professional | 55 · Aftercare only | $14.13 | $14.79 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.77 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.33 | $9.77 | $12.88 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $109.65 Median $128.82 Typical High $181.97 | Professional | 25 · Same-day visit | $109.65 | $128.82 | $181.97 |
Ambetter Setting Professional Modifier FP · Family planning Typical Low $97.72 Median $97.72 Typical High $109.65 | Professional | FP · Family planning | $97.72 | $97.72 | $109.65 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $50.12 Median $57.54 Typical High $81.28 | Professional | 51 · Multiple procedures | $50.12 | $57.54 | $81.28 |
Where North Carolina sits
The same service costs 2.7 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
$186
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.