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 $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $5.62 Typical High $5.62 | Professional | None | $4.07 | $5.62 | $5.62 |
Ambetter Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
BCBS North Carolina Setting Facility Modifier None Typical Low $5.25 Median $6.31 Typical High $6.61 | Facility | None | $5.25 | $6.31 | $6.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $4.68 Median $4.79 Typical High $5.13 | Professional | None | $4.68 | $4.79 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
Medcost Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Medcost Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $8.91 | Facility | None | $3.55 | $3.55 | $8.91 |
Medcost Setting Professional Modifier None Typical Low $4.27 Median $5.01 Typical High $10.72 | Professional | None | $4.27 | $5.01 | $10.72 |
United Setting Professional Modifier None Typical Low $2.45 Median $3.16 Typical High $3.72 | Professional | None | $2.45 | $3.16 | $3.72 |
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 $0.68 Median $0.83 Typical High $0.83 | Professional | 55 · Aftercare only | $0.68 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.56 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.45 | $0.56 | $0.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.40 Median $2.51 Typical High $7.59 | Professional | 51 · Multiple procedures | $2.40 | $2.51 | $7.59 |
Where North Carolina sits
The same service costs 2.5 times more in Idaho than in Colorado. 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· 20th of 51
$4.79
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.