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 $0.46 Median $0.47 Typical High $0.47 | Facility | None | $0.46 | $0.47 | $0.47 |
Aetna Setting Professional Modifier None Typical Low $0.30 Median $0.47 Typical High $0.47 | Professional | None | $0.30 | $0.47 | $0.47 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
BCBS Setting Facility Modifier None Typical Low $0.46 Median $0.55 Typical High $0.72 | Facility | None | $0.46 | $0.55 | $0.72 |
BCBS Setting Professional Modifier None Typical Low $0.39 Median $0.40 Typical High $0.43 | Professional | None | $0.39 | $0.40 | $0.43 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Medcost Setting Professional Modifier None Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | None | $0.43 | $0.43 | $0.43 |
Medcost Setting Facility Modifier None Typical Low $0.47 Median $0.65 Typical High $0.78 | Facility | None | $0.47 | $0.65 | $0.78 |
Medcost Setting Professional Modifier None Typical Low $0.14 Median $0.42 Typical High $0.72 | Professional | None | $0.14 | $0.42 | $0.72 |
United Setting Professional Modifier None Typical Low $0.21 Median $0.27 Typical High $0.31 | Professional | None | $0.21 | $0.27 | $0.31 |
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 $0.19 Median $0.24 Typical High $0.24 | Professional | 52 · Reduced service | $0.19 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.09 Typical High $0.09 | Professional | 53 · Discontinued | $0.08 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.06 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.04 | $0.05 | $0.05 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | RR · Rental | $0.05 | $0.05 | $0.06 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.07 Median $0.21 Typical High $0.65 | Professional | 51 · Multiple procedures | $0.07 | $0.21 | $0.65 |
Where North Carolina sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 22nd of 51
$0.40
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.