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 $1.41 Median $1.41 Typical High $1.41 | Facility | None | $1.41 | $1.41 | $1.41 |
Aetna Setting Professional Modifier None Typical Low $1.12 Median $1.41 Typical High $1.41 | Professional | None | $1.12 | $1.41 | $1.41 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1.07 Median $1.07 Typical High $1.17 | Professional | None | $1.07 | $1.07 | $1.17 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
Medcost Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Medcost Setting Facility Modifier None Typical Low $1.70 Median $10.96 Typical High $10.96 | Facility | None | $1.70 | $10.96 | $10.96 |
Medcost Setting Professional Modifier None Typical Low $12.30 Median $12.59 Typical High $16.22 | Professional | None | $12.30 | $12.59 | $16.22 |
United Setting Professional Modifier None Typical Low $0.56 Median $1.41 Typical High $8.71 | Professional | None | $0.56 | $1.41 | $8.71 |
4 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 55 · Aftercare only Typical Low $0.16 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.16 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.11 | $0.14 | $0.14 |
Ambetter Setting Professional Modifier KS · Glucose supply, no insulin Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | KS · Glucose supply, no insulin | $1.12 | $1.12 | $1.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.32 Median $6.31 Typical High $7.08 | Professional | 51 · Multiple procedures | $1.32 | $6.31 | $7.08 |
Where North Carolina sits
The same service costs 7.4 times more in Kentucky than in Delaware. 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· 43rd of 51
$1.07
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.