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 $0.95 Median $0.95 Typical High $0.95 | Facility | None | $0.95 | $0.95 | $0.95 |
Aetna Setting Professional Modifier None Typical Low $0.69 Median $0.95 Typical High $0.95 | Professional | None | $0.69 | $0.95 | $0.95 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
BCBS North Carolina Setting Facility Modifier None Typical Low $0.89 Median $1.15 Typical High $1.48 | Facility | None | $0.89 | $1.15 | $1.48 |
BCBS North Carolina Setting Professional Modifier None Typical Low $0.81 Median $0.83 Typical High $0.89 | Professional | None | $0.81 | $0.83 | $0.89 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Medcost Setting Professional Modifier None Typical Low $0.78 Median $0.78 Typical High $0.78 | Professional | None | $0.78 | $0.78 | $0.78 |
Medcost Setting Facility Modifier None Typical Low $0.95 Median $1.32 Typical High $1.55 | Facility | None | $0.95 | $1.32 | $1.55 |
Medcost Setting Professional Modifier None Typical Low $0.81 Median $0.81 Typical High $1.82 | Professional | None | $0.81 | $0.81 | $1.82 |
United Setting Professional Modifier None Typical Low $0.39 Median $0.54 Typical High $0.62 | Professional | None | $0.39 | $0.54 | $0.62 |
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 $0.35 Median $0.48 Typical High $0.48 | Professional | 52 · Reduced service | $0.35 | $0.48 | $0.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.14 Median $0.19 Typical High $0.19 | Professional | 53 · Discontinued | $0.14 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.14 Typical High $0.14 | Professional | 55 · Aftercare only | $0.10 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.07 | $0.10 | $0.10 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.40 Median $0.40 Typical High $1.29 | Professional | 51 · Multiple procedures | $0.40 | $0.40 | $1.29 |
Where North Carolina sits
The same service costs 2.6 times more in Hawaii than in Utah. 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
$0.83
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.