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 $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $7.94 Typical High $7.94 | Professional | None | $6.46 | $7.94 | $7.94 |
Ambetter Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | None | $6.61 | $6.61 | $6.61 |
BCBS North Carolina Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
BCBS North Carolina Setting Professional Modifier None Typical Low $6.76 Median $7.08 Typical High $7.41 | Professional | None | $6.76 | $7.08 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Medcost Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Medcost Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $12.88 | Facility | None | $6.03 | $6.03 | $12.88 |
Medcost Setting Professional Modifier None Typical Low $6.61 Median $7.08 Typical High $15.49 | Professional | None | $6.61 | $7.08 | $15.49 |
United Setting Professional Modifier None Typical Low $3.55 Median $4.57 Typical High $5.37 | Professional | None | $3.55 | $4.57 | $5.37 |
3 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 $1.00 Median $1.20 Typical High $1.20 | Professional | 55 · Aftercare only | $1.00 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $0.79 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.68 | $0.79 | $0.79 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.47 Median $3.47 Typical High $10.96 | Professional | 51 · Multiple procedures | $3.47 | $3.47 | $10.96 |
Where North Carolina sits
The same service costs 3.3 times more in Hawaii than in Utah. 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· 19th of 51
$7.08
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.