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 $3.31 Median $3.31 Typical High $7.08 | Facility | None | $3.31 | $3.31 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $3.31 Typical High $3.89 | Professional | None | $2.88 | $3.31 | $3.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4.27 Median $5.62 Typical High $6.61 | Facility | None | $4.27 | $5.62 | $6.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3.80 Median $4.17 Typical High $6.92 | Professional | None | $3.80 | $4.17 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $4.68 Typical High $6.17 | Facility | None | $4.07 | $4.68 | $6.17 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Medcost Setting Facility Modifier None Typical Low $3.31 Median $3.31 Typical High $3.47 | Facility | None | $3.31 | $3.31 | $3.47 |
Medcost Setting Professional Modifier None Typical Low $8.32 Median $12.02 Typical High $15.85 | Professional | None | $8.32 | $12.02 | $15.85 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.47 Typical High $3.47 | Professional | None | $3.24 | $3.47 | $3.47 |
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 $1.45 Median $1.66 Typical High $1.66 | Professional | 52 · Reduced service | $1.45 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.68 Typical High $0.68 | Professional | 53 · Discontinued | $0.58 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.50 Typical High $0.50 | Professional | 55 · Aftercare only | $0.43 | $0.50 | $0.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.33 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.28 | $0.33 | $0.33 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | JZ · No drug discarded | $3.24 | $3.24 | $3.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.39 Median $5.75 Typical High $8.13 | Professional | 51 · Multiple procedures | $3.39 | $5.75 | $8.13 |
Where North Carolina sits
The same service costs 3.1 times more in Wyoming than in Delaware. 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· 4th of 51
$3.80
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.