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 $1.26 Median $1.26 Typical High $1.26 | Facility | None | $1.26 | $1.26 | $1.26 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
BCBS North Carolina Setting Professional Modifier None Typical Low $6.92 Median $9.12 Typical High $9.55 | Professional | None | $6.92 | $9.12 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
Medcost Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $1.32 | Facility | None | $1.26 | $1.26 | $1.32 |
Medcost Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | None | $2.40 | $2.40 | $2.40 |
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 $0.63 Median $0.63 Typical High $0.63 | Professional | 52 · Reduced service | $0.63 | $0.63 | $0.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | 53 · Discontinued | $0.25 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 51 · Multiple procedures | $1.20 | $1.20 | $1.20 |
Where North Carolina sits
The same service costs 316.2 times more in Montana than in Arkansas. 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· 22nd of 51
$9.12
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.