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 $4.17 Median $4.17 Typical High $4.17 | Facility | None | $4.17 | $4.17 | $4.17 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $4.17 Typical High $4.17 | Professional | None | $3.02 | $4.17 | $4.17 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3.47 Median $3.63 Typical High $3.98 | Professional | None | $3.47 | $3.63 | $3.98 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Medcost Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Medcost Setting Facility Modifier None Typical Low $4.17 Median $5.75 Typical High $6.61 | Facility | None | $4.17 | $5.75 | $6.61 |
Medcost Setting Professional Modifier None Typical Low $3.55 Median $3.98 Typical High $7.94 | Professional | None | $3.55 | $3.98 | $7.94 |
United Setting Professional Modifier None Typical Low $1.70 Median $2.34 Typical High $2.69 | Professional | None | $1.70 | $2.34 | $2.69 |
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 $1.51 Median $2.09 Typical High $2.09 | Professional | 52 · Reduced service | $1.51 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.83 Typical High $0.83 | Professional | 53 · Discontinued | $0.60 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.63 Typical High $0.63 | Professional | 55 · Aftercare only | $0.45 | $0.63 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.42 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.30 | $0.42 | $0.42 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.78 Median $2.00 Typical High $5.62 | Professional | 51 · Multiple procedures | $1.78 | $2.00 | $5.62 |
Where North Carolina sits
The same service costs 2.6 times more in Hawaii than in Maine. 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
$3.63
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.