How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $0.85 Median $3.55 Typical High $3.55 | Professional | None | $0.85 | $3.55 | $3.55 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1.00 Median $3.31 Typical High $4.68 | Professional | None | $1.00 | $3.31 | $4.68 |
Cigna Setting Facility Modifier None Typical Low $0.98 Median $1.29 Typical High $1.82 | Facility | None | $0.98 | $1.29 | $1.82 |
Cigna Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | None | $0.85 | $0.85 | $0.85 |
Medcost Setting Facility Modifier None Typical Low $1.02 Median $1.02 Typical High $3.55 | Facility | None | $1.02 | $1.02 | $3.55 |
Medcost Setting Professional Modifier None Typical Low $3.39 Median $5.13 Typical High $5.13 | Professional | None | $3.39 | $5.13 | $5.13 |
Oscar Health Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $1.00 | Professional | None | $0.62 | $0.62 | $1.00 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
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 $0.43 Median $1.78 Typical High $1.78 | Professional | 52 · Reduced service | $0.43 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.17 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.54 Typical High $0.54 | Professional | 55 · Aftercare only | $0.13 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.09 | $0.36 | $0.36 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 51 · Multiple procedures | $2.57 | $2.57 | $2.57 |
Where North Carolina sits
The same service costs 3.7 times more in North Carolina than in Virginia. 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· 1st of 51
$3.16
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.