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 $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $15.14 | Professional | None | $14.13 | $14.13 | $15.14 |
BCBS North Carolina Setting Professional Modifier None Typical Low $18.62 Median $22.39 Typical High $23.99 | Professional | None | $18.62 | $22.39 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $10.72 Typical High $10.72 | Professional | None | $7.76 | $10.72 | $10.72 |
Medcost Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $16.98 | Facility | None | $14.13 | $14.13 | $16.98 |
4 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 $7.08 Median $7.08 Typical High $7.59 | Professional | 52 · Reduced service | $7.08 | $7.08 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $3.09 | Professional | 53 · Discontinued | $2.82 | $2.82 | $3.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.09 Typical High $2.29 | Professional | 55 · Aftercare only | $2.09 | $2.09 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.41 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.41 | $1.41 | $1.51 |
Where North Carolina sits
The same service costs 27.5 times more in Kansas than in South Carolina. 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· 21st of 51
$22.39
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.