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 $0.08 Median $0.08 Typical High $0.08 | Facility | None | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $0.12 | Professional | None | $0.08 | $0.08 | $0.12 |
BCBS North Carolina Setting Professional Modifier None Typical Low $0.14 Median $0.14 Typical High $0.20 | Professional | None | $0.14 | $0.14 | $0.20 |
Cigna Setting Facility Modifier None Typical Low $0.15 Median $0.17 Typical High $0.28 | Facility | None | $0.15 | $0.17 | $0.28 |
Cigna Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | None | $0.13 | $0.13 | $0.13 |
Medcost Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
Medcost Setting Facility Modifier None Typical Low $0.08 Median $0.08 Typical High $0.08 | Facility | None | $0.08 | $0.08 | $0.08 |
Medcost Setting Professional Modifier None Typical Low $0.04 Median $0.15 Typical High $0.22 | Professional | None | $0.04 | $0.15 | $0.22 |
United Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | None | $0.13 | $0.13 | $0.13 |
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 $0.04 Median $0.04 Typical High $0.06 | Professional | 52 · Reduced service | $0.04 | $0.04 | $0.06 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.02 Median $0.11 Typical High $0.66 | Professional | 51 · Multiple procedures | $0.02 | $0.11 | $0.66 |
Where North Carolina sits
The same service costs 32.4 times more in Montana than in Hawaii. 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· 5th of 51
$0.14
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.