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 $2.14 Median $2.14 Typical High $2.14 | Facility | None | $2.14 | $2.14 | $2.14 |
Aetna Setting Professional Modifier None Typical Low $1.78 Median $2.14 Typical High $2.14 | Professional | None | $1.78 | $2.14 | $2.14 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2.09 Median $2.51 Typical High $2.57 | Facility | None | $2.09 | $2.51 | $2.57 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1.82 Median $1.86 Typical High $2.00 | Professional | None | $1.82 | $1.86 | $2.00 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $1.12 | Professional | None | $1.02 | $1.12 | $1.12 |
Medcost Setting Facility Modifier None Typical Low $2.14 Median $2.57 Typical High $3.39 | Facility | None | $2.14 | $2.57 | $3.39 |
Medcost Setting Professional Modifier None Typical Low $1.95 Median $2.45 Typical High $8.91 | Professional | None | $1.95 | $2.45 | $8.91 |
United Setting Professional Modifier None Typical Low $0.87 Median $1.20 Typical High $1.45 | Professional | None | $0.87 | $1.20 | $1.45 |
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 $0.89 Median $1.07 Typical High $1.07 | Professional | 52 · Reduced service | $0.89 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.35 Median $0.43 Typical High $0.43 | Professional | 53 · Discontinued | $0.35 | $0.43 | $0.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.32 Typical High $0.32 | Professional | 55 · Aftercare only | $0.27 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.21 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.18 | $0.21 | $0.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.98 Median $1.95 Typical High $4.47 | Professional | 51 · Multiple procedures | $0.98 | $1.95 | $4.47 |
Where North Carolina sits
The same service costs 4.6 times more in Rhode Island 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· 20th of 51
$1.86
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.