How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $72.44 Median $85.11 Typical High $114.82 | Facility | None | $72.44 | $85.11 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $79.43 Typical High $87.10 | Professional | None | $69.18 | $79.43 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $123.03 Typical High $154.88 | Professional | None | $120.23 | $123.03 | $154.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $204.17 | Professional | None | $102.33 | $144.54 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $144.54 | Professional | None | $69.18 | $95.50 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $162.18 | Professional | None | $93.33 | $114.82 | $162.18 |
Medcost Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $102.33 | Facility | None | $72.44 | $85.11 | $102.33 |
Medcost Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $109.65 | Professional | None | $67.61 | $93.33 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $186.21 | Professional | None | $112.20 | $141.25 | $186.21 |
United Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $131.83 | Professional | None | $64.57 | $79.43 | $131.83 |
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 $34.67 Median $35.48 Typical High $42.66 | Professional | 52 · Reduced service | $34.67 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $12.88 | Professional | 55 · Aftercare only | $10.47 | $10.72 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.24 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.92 | $7.24 | $8.51 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 25 · Same-day visit | $154.88 | $154.88 | $154.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.88 Median $46.77 Typical High $54.95 | Professional | 51 · Multiple procedures | $33.88 | $46.77 | $54.95 |
Where North Carolina sits
The same service costs 2.9 times more in Alaska than in Florida. 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
$132
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.