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 $3.24 Median $3.24 Typical High $3.39 | Facility | None | $3.24 | $3.24 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $3.24 Typical High $3.24 | Professional | None | $2.14 | $3.24 | $3.24 |
Ambetter Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3.09 Median $3.72 Typical High $3.89 | Facility | None | $3.09 | $3.72 | $3.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2.75 Median $2.82 Typical High $3.16 | Professional | None | $2.75 | $2.82 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Medcost Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
Medcost Setting Facility Modifier None Typical Low $3.24 Median $4.57 Typical High $5.25 | Facility | None | $3.24 | $4.57 | $5.25 |
Medcost Setting Professional Modifier None Typical Low $2.82 Median $3.47 Typical High $7.41 | Professional | None | $2.82 | $3.47 | $7.41 |
United Setting Professional Modifier None Typical Low $1.45 Median $1.86 Typical High $2.19 | Professional | None | $1.45 | $1.86 | $2.19 |
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 $1.38 Median $1.62 Typical High $1.62 | Professional | 52 · Reduced service | $1.38 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.55 Median $0.65 Typical High $0.65 | Professional | 53 · Discontinued | $0.55 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.49 Typical High $0.49 | Professional | 55 · Aftercare only | $0.42 | $0.49 | $0.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.33 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.28 | $0.33 | $0.33 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.41 Median $1.41 Typical High $4.47 | Professional | 51 · Multiple procedures | $1.41 | $1.41 | $4.47 |
Where North Carolina sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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· 18th of 51
$2.82
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.