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 $114.82 Median $114.82 Typical High $147.91 | Facility | None | $114.82 | $114.82 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $177.83 | Professional | None | $114.82 | $138.04 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $208.93 | Professional | None | $125.89 | $147.91 | $208.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $346.74 | Professional | None | $147.91 | $223.87 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $229.09 | Professional | None | $107.15 | $147.91 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $194.98 | Professional | None | $131.83 | $165.96 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $144.54 Typical High $177.83 | Facility | None | $114.82 | $144.54 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $177.83 | Professional | None | $114.82 | $134.90 | $177.83 |
Oscar Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $288.40 | Professional | None | $141.25 | $141.25 | $288.40 |
United Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $208.93 | Professional | None | $91.20 | $131.83 | $208.93 |
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 $56.23 Median $57.54 Typical High $74.13 | Professional | 52 · Reduced service | $56.23 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.38 Typical High $22.39 | Professional | 55 · Aftercare only | $16.98 | $17.38 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.48 Typical High $14.79 | Professional | 56 · Pre-op care only | $11.22 | $11.48 | $14.79 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $125.89 Median $147.91 Typical High $229.09 | Professional | 25 · Same-day visit | $125.89 | $147.91 | $229.09 |
Ambetter Setting Professional Modifier CC · Code corrected Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | CC · Code corrected | $208.93 | $208.93 | $208.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $67.61 Typical High $93.33 | Professional | 51 · Multiple procedures | $57.54 | $67.61 | $93.33 |
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· 5th of 51
$219
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.