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 $0.65 Median $0.65 Typical High $0.65 | Facility | None | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier None Typical Low $0.48 Median $0.65 Typical High $0.65 | Professional | None | $0.48 | $0.65 | $0.65 |
BCBS North Carolina Setting Facility Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Facility | None | $0.65 | $0.65 | $0.65 |
BCBS North Carolina Setting Professional Modifier None Typical Low $0.45 Median $0.46 Typical High $0.47 | Professional | None | $0.45 | $0.46 | $0.47 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Medcost Setting Facility Modifier None Typical Low $0.65 Median $0.65 Typical High $0.68 | Facility | None | $0.65 | $0.65 | $0.68 |
Medcost Setting Professional Modifier None Typical Low $0.44 Median $0.74 Typical High $8.32 | Professional | None | $0.44 | $0.74 | $8.32 |
United Setting Professional Modifier None Typical Low $0.27 Median $0.40 Typical High $0.50 | Professional | None | $0.27 | $0.40 | $0.50 |
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 $0.08 Median $0.10 Typical High $0.10 | Professional | 55 · Aftercare only | $0.08 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.06 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.22 Median $0.37 Typical High $4.17 | Professional | 51 · Multiple procedures | $0.22 | $0.37 | $4.17 |
Where North Carolina sits
The same service costs 2.9 times more in Minnesota than in Ohio. 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· 42nd of 51
$0.47
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.