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 $83.18 Median $83.18 Typical High $112.20 | Facility | None | $83.18 | $83.18 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $134.90 | Professional | None | $83.18 | $104.71 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $158.49 | Professional | None | $87.10 | $97.72 | $158.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $263.03 | Professional | None | $107.15 | $165.96 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $169.82 | Professional | None | $77.62 | $102.33 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $112.20 Typical High $131.83 | Professional | None | $91.20 | $112.20 | $131.83 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $102.33 Typical High $134.90 | Facility | None | $83.18 | $102.33 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $134.90 | Professional | None | $87.10 | $102.33 | $134.90 |
Oscar Health Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $251.19 | Professional | None | $131.83 | $165.96 | $251.19 |
United Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $162.18 | Professional | None | $64.57 | $91.20 | $162.18 |
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 $41.69 Median $43.65 Typical High $56.23 | Professional | 52 · Reduced service | $41.69 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.18 Typical High $16.60 | Professional | 55 · Aftercare only | $12.30 | $13.18 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.71 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.32 | $8.71 | $11.22 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $97.72 Median $114.82 Typical High $165.96 | Professional | 25 · Same-day visit | $97.72 | $114.82 | $165.96 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | EP · Child screening program | $114.82 | $114.82 | $114.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $43.65 Median $50.12 Typical High $69.18 | Professional | 51 · Multiple procedures | $43.65 | $50.12 | $69.18 |
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· 6th 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.