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 $0.83 Median $0.83 Typical High $0.83 | Facility | None | $0.83 | $0.83 | $0.83 |
Aetna Setting Professional Modifier None Typical Low $0.62 Median $0.83 Typical High $0.83 | Professional | None | $0.62 | $0.83 | $0.83 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
BCBS North Carolina Setting Facility Modifier None Typical Low $0.78 Median $1.00 Typical High $1.29 | Facility | None | $0.78 | $1.00 | $1.29 |
BCBS North Carolina Setting Professional Modifier None Typical Low $0.71 Median $0.72 Typical High $0.78 | Professional | None | $0.71 | $0.72 | $0.78 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Medcost Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | None | $0.68 | $0.68 | $0.68 |
Medcost Setting Facility Modifier None Typical Low $0.83 Median $1.15 Typical High $1.35 | Facility | None | $0.83 | $1.15 | $1.35 |
Medcost Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $1.58 | Professional | None | $0.71 | $0.71 | $1.58 |
United Setting Professional Modifier None Typical Low $0.34 Median $0.47 Typical High $0.54 | Professional | None | $0.34 | $0.47 | $0.54 |
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 $0.31 Median $0.42 Typical High $0.42 | Professional | 52 · Reduced service | $0.31 | $0.42 | $0.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.17 Typical High $0.17 | Professional | 53 · Discontinued | $0.12 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.13 Typical High $0.13 | Professional | 55 · Aftercare only | $0.09 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.06 | $0.08 | $0.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.35 Median $0.35 Typical High $1.15 | Professional | 51 · Multiple procedures | $0.35 | $0.35 | $1.15 |
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
$0.72
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.