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 $1.48 Median $1.48 Typical High $1.48 | Facility | None | $1.48 | $1.48 | $1.48 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.48 Typical High $1.48 | Professional | None | $1.23 | $1.48 | $1.48 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1.38 Median $1.66 Typical High $1.78 | Facility | None | $1.38 | $1.66 | $1.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1.26 Median $1.29 Typical High $1.45 | Professional | None | $1.26 | $1.29 | $1.45 |
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 $1.45 Median $1.45 Typical High $1.45 | Professional | None | $1.45 | $1.45 | $1.45 |
Medcost Setting Facility Modifier None Typical Low $1.48 Median $2.04 Typical High $2.40 | Facility | None | $1.48 | $2.04 | $2.40 |
Medcost Setting Professional Modifier None Typical Low $1.29 Median $2.00 Typical High $9.77 | Professional | None | $1.29 | $2.00 | $9.77 |
United Setting Professional Modifier None Typical Low $0.66 Median $0.85 Typical High $1.00 | Professional | None | $0.66 | $0.85 | $1.00 |
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 $0.18 Median $0.22 Typical High $0.22 | Professional | 55 · Aftercare only | $0.18 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.12 | $0.15 | $0.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.56 Median $1.00 Typical High $2.04 | Professional | 51 · Multiple procedures | $0.56 | $1.00 | $2.04 |
Where North Carolina sits
The same service costs 3.1 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· 21st of 51
$1.29
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.