How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.35 Median $0.36 Typical High $0.36 | Facility | None | $0.35 | $0.36 | $0.36 |
Aetna Setting Professional Modifier None Typical Low $0.34 Median $0.36 Typical High $0.36 | Professional | None | $0.34 | $0.36 | $0.36 |
BCBS Setting Facility Modifier None Typical Low $0.10 Median $0.10 Typical High $0.12 | Facility | None | $0.10 | $0.10 | $0.12 |
BCBS Setting Professional Modifier None Typical Low $0.04 Median $0.36 Typical High $0.41 | Professional | None | $0.04 | $0.36 | $0.41 |
Cigna Setting Facility Modifier None Typical Low $0.40 Median $0.44 Typical High $0.79 | Facility | None | $0.40 | $0.44 | $0.79 |
Cigna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Medcost Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
Medcost Setting Facility Modifier None Typical Low $0.36 Median $0.36 Typical High $0.38 | Facility | None | $0.36 | $0.36 | $0.38 |
Medcost Setting Professional Modifier None Typical Low $0.04 Median $0.41 Typical High $0.58 | Professional | None | $0.04 | $0.41 | $0.58 |
United Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | None | $0.34 | $0.34 | $0.34 |
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 $0.17 Median $0.18 Typical High $0.18 | Professional | 52 · Reduced service | $0.17 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.02 Median $0.11 Typical High $0.28 | Professional | 51 · Multiple procedures | $0.02 | $0.11 | $0.28 |
Where North Carolina sits
The same service costs 1.6 times more in Montana 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· 6th of 51
$0.36
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.