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 $0.48 Median $0.48 Typical High $0.48 | Facility | None | $0.48 | $0.48 | $0.48 |
Aetna Setting Professional Modifier None Typical Low $0.46 Median $0.48 Typical High $0.48 | Professional | None | $0.46 | $0.48 | $0.48 |
BCBS North Carolina Setting Professional Modifier None Typical Low $0.49 Median $0.54 Typical High $1.29 | Professional | None | $0.49 | $0.54 | $1.29 |
Cigna Setting Facility Modifier None Typical Low $0.54 Median $0.62 Typical High $1.02 | Facility | None | $0.54 | $0.62 | $1.02 |
Cigna Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | None | $0.48 | $0.48 | $0.48 |
Medcost 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 Facility Modifier None Typical Low $0.48 Median $0.48 Typical High $0.51 | Facility | None | $0.48 | $0.48 | $0.51 |
Medcost Setting Professional Modifier None Typical Low $0.56 Median $0.63 Typical High $0.89 | Professional | None | $0.56 | $0.63 | $0.89 |
United Setting Professional Modifier None Typical Low $0.47 Median $0.47 Typical High $0.47 | Professional | None | $0.47 | $0.47 | $0.47 |
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 $0.23 Median $0.24 Typical High $0.24 | Professional | 52 · Reduced service | $0.23 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.10 Typical High $0.10 | Professional | 53 · Discontinued | $0.09 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.22 Median $0.32 Typical High $0.44 | Professional | 51 · Multiple procedures | $0.22 | $0.32 | $0.44 |
Where North Carolina sits
The same service costs 2.3 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· 9th of 51
$0.49
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.