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 $0.30 Median $0.30 Typical High $0.30 | Facility | None | $0.30 | $0.30 | $0.30 |
Aetna Setting Professional Modifier None Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | None | $0.30 | $0.30 | $0.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $28.18 Median $37.15 Typical High $38.02 | Professional | None | $28.18 | $37.15 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | None | $0.58 | $0.58 | $0.58 |
Medcost Setting Facility Modifier None Typical Low $0.30 Median $0.30 Typical High $0.32 | Facility | None | $0.30 | $0.30 | $0.32 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Where North Carolina sits
The same service costs 263.0 times more in Montana than in Idaho. 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· 2nd of 51
$37.15
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.