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 $48.98 Median $63.10 Typical High $64.57 | Facility | None | $48.98 | $63.10 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $63.10 | Professional | None | $46.77 | $54.95 | $63.10 |
Ambetter Setting Professional Modifier None Typical Low $52.48 Median $75.86 Typical High $89.13 | Professional | None | $52.48 | $75.86 | $89.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $144.54 | Professional | None | $69.18 | $100.00 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $66.07 Typical High $100.00 | Professional | None | $47.86 | $66.07 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $66.07 Median $83.18 Typical High $120.23 | Professional | None | $66.07 | $83.18 | $120.23 |
Medcost Setting Facility Modifier None Typical Low $48.98 Median $63.10 Typical High $75.86 | Facility | None | $48.98 | $63.10 | $75.86 |
Medcost Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $79.43 | Professional | None | $48.98 | $66.07 | $79.43 |
Oscar Health Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $138.04 | Professional | None | $75.86 | $95.50 | $138.04 |
United Setting Professional Modifier None Typical Low $43.65 Median $57.54 Typical High $93.33 | Professional | None | $43.65 | $57.54 | $93.33 |
5 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 $23.99 Median $24.55 Typical High $31.62 | Professional | 52 · Reduced service | $23.99 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $9.33 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.90 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.79 | $4.90 | $6.31 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $52.48 Median $89.13 Typical High $89.13 | Professional | 25 · Same-day visit | $52.48 | $89.13 | $89.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $24.55 Median $33.11 Typical High $39.81 | Professional | 51 · Multiple procedures | $24.55 | $33.11 | $39.81 |
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
$89.13
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.