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 $85.11 Median $85.11 Typical High $114.82 | Facility | None | $85.11 | $85.11 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $138.04 | Professional | None | $85.11 | $107.15 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $190.55 | Professional | None | $89.13 | $134.90 | $190.55 |
BCBS North Carolina Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $269.15 | Professional | None | $107.15 | $169.82 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $173.78 | Professional | None | $77.62 | $102.33 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $134.90 | Professional | None | $91.20 | $114.82 | $134.90 |
Medcost Setting Facility Modifier None Typical Low $85.11 Median $102.33 Typical High $138.04 | Facility | None | $85.11 | $102.33 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $102.33 Typical High $138.04 | Professional | None | $89.13 | $102.33 | $138.04 |
Oscar Health Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $257.04 | Professional | None | $134.90 | $169.82 | $257.04 |
United Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $162.18 | Professional | None | $64.57 | $93.33 | $162.18 |
7 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 $42.66 Median $44.67 Typical High $57.54 | Professional | 52 · Reduced service | $42.66 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.18 Typical High $16.98 | Professional | 55 · Aftercare only | $12.88 | $13.18 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.91 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.51 | $8.91 | $11.48 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $97.72 Median $117.49 Typical High $177.83 | Professional | 25 · Same-day visit | $97.72 | $117.49 | $177.83 |
Ambetter Setting Professional Modifier FP · Family planning Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | FP · Family planning | $97.72 | $97.72 | $97.72 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $141.25 Median $190.55 Typical High $190.55 | Professional | GC · Resident with teaching physician | $141.25 | $190.55 | $190.55 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $44.67 Median $51.29 Typical High $69.18 | Professional | 51 · Multiple procedures | $44.67 | $51.29 | $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
$166
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.