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 $2.29 Median $2.29 Typical High $2.29 | Facility | None | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier None Typical Low $1.66 Median $2.29 Typical High $2.29 | Professional | None | $1.66 | $2.29 | $2.29 |
Ambetter Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2.75 Median $3.55 Typical High $3.55 | Facility | None | $2.75 | $3.55 | $3.55 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1.91 Median $2.00 Typical High $2.14 | Professional | None | $1.91 | $2.00 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Medcost Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Medcost Setting Facility Modifier None Typical Low $2.29 Median $3.16 Typical High $3.72 | Facility | None | $2.29 | $3.16 | $3.72 |
Medcost Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $4.37 | Professional | None | $1.95 | $1.95 | $4.37 |
United Setting Professional Modifier None Typical Low $0.93 Median $1.29 Typical High $1.51 | Professional | None | $0.93 | $1.29 | $1.51 |
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 $0.83 Median $1.15 Typical High $1.15 | Professional | 52 · Reduced service | $0.83 | $1.15 | $1.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.33 Median $0.46 Typical High $0.46 | Professional | 53 · Discontinued | $0.33 | $0.46 | $0.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.34 Typical High $0.34 | Professional | 55 · Aftercare only | $0.25 | $0.34 | $0.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.23 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.17 | $0.23 | $0.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.98 Median $0.98 Typical High $3.09 | Professional | 51 · Multiple procedures | $0.98 | $0.98 | $3.09 |
Where North Carolina sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 19th of 51
$2.00
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.