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 $0.40 Median $0.40 Typical High $3.09 | Facility | None | $0.40 | $0.40 | $3.09 |
Aetna Setting Professional Modifier None Typical Low $0.20 Median $0.40 Typical High $0.40 | Professional | None | $0.20 | $0.40 | $0.40 |
BCBS North Carolina Setting Professional Modifier None Typical Low $0.16 Median $0.27 Typical High $1.07 | Professional | None | $0.16 | $0.27 | $1.07 |
Cigna Setting Facility Modifier None Typical Low $0.28 Median $0.30 Typical High $0.42 | Facility | None | $0.28 | $0.30 | $0.42 |
Cigna Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | None | $0.20 | $0.20 | $0.20 |
Medcost Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
Medcost Setting Facility Modifier None Typical Low $0.24 Median $0.24 Typical High $0.40 | Facility | None | $0.24 | $0.24 | $0.40 |
Medcost Setting Professional Modifier None Typical Low $1.07 Median $1.26 Typical High $1.26 | Professional | None | $1.07 | $1.26 | $1.26 |
United Setting Professional Modifier None Typical Low $0.16 Median $0.17 Typical High $0.18 | Professional | None | $0.16 | $0.17 | $0.18 |
6 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 $0.10 Median $0.20 Typical High $0.20 | Professional | 52 · Reduced service | $0.10 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.04 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.03 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.02 | $0.04 | $0.04 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | JZ · No drug discarded | $5.50 | $5.50 | $5.50 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.58 Median $0.65 Typical High $0.65 | Professional | 51 · Multiple procedures | $0.58 | $0.65 | $0.65 |
Where North Carolina sits
The same service costs 3.8 times more in Wyoming than in Michigan. 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· 25th of 51
$0.20
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.