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 $1.78 Median $1.78 Typical High $9.33 | Facility | None | $1.78 | $1.78 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $1.32 Median $1.78 Typical High $1.78 | Professional | None | $1.32 | $1.78 | $1.78 |
Ambetter Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1.62 Median $2.51 Typical High $2.88 | Facility | None | $1.62 | $2.51 | $2.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1.45 Median $1.58 Typical High $2.51 | Professional | None | $1.45 | $1.58 | $2.51 |
Cigna Setting Facility Modifier None Typical Low $1.82 Median $2.09 Typical High $2.75 | Facility | None | $1.82 | $2.09 | $2.75 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Medcost Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Medcost Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.78 | Facility | None | $1.55 | $1.55 | $1.78 |
Medcost Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $6.03 | Professional | None | $4.68 | $4.68 | $6.03 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.41 Typical High $1.45 | Professional | None | $1.32 | $1.41 | $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 $0.66 Median $0.89 Typical High $0.89 | Professional | 52 · Reduced service | $0.66 | $0.89 | $0.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.36 Typical High $0.36 | Professional | 53 · Discontinued | $0.26 | $0.36 | $0.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.27 Typical High $0.27 | Professional | 55 · Aftercare only | $0.20 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.18 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.13 | $0.18 | $0.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.14 Median $2.34 Typical High $2.34 | Professional | 51 · Multiple procedures | $2.14 | $2.34 | $2.34 |
Where North Carolina sits
The same service costs 1.9 times more in Wyoming than in Florida. 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· 10th of 51
$1.45
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.