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 $0.28 Median $0.28 Typical High $0.28 | Facility | None | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier None Typical Low $0.21 Median $0.28 Typical High $0.28 | Professional | None | $0.21 | $0.28 | $0.28 |
BCBS North Carolina Setting Facility Modifier None Typical Low $0.36 Median $0.47 Typical High $0.47 | Facility | None | $0.36 | $0.47 | $0.47 |
BCBS North Carolina Setting Professional Modifier None Typical Low $0.25 Median $0.26 Typical High $0.28 | Professional | None | $0.25 | $0.26 | $0.28 |
Cigna Setting Professional Modifier None Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | None | $0.17 | $0.17 | $0.17 |
Medcost Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Medcost Setting Facility Modifier None Typical Low $0.29 Median $0.35 Typical High $0.46 | Facility | None | $0.29 | $0.35 | $0.46 |
Medcost Setting Professional Modifier None Typical Low $0.24 Median $0.26 Typical High $0.28 | Professional | None | $0.24 | $0.26 | $0.28 |
United Setting Professional Modifier None Typical Low $0.12 Median $0.17 Typical High $0.20 | Professional | None | $0.12 | $0.17 | $0.20 |
2 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | AU · Urologic/ostomy supply | $25.70 | $25.70 | $25.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.13 Median $0.13 Typical High $0.40 | Professional | 51 · Multiple procedures | $0.13 | $0.13 | $0.40 |
Where North Carolina sits
The same service costs 2.9 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· 18th of 51
$0.26
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.