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 $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $4.68 Typical High $4.68 | Professional | None | $3.89 | $4.68 | $4.68 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3.98 Median $4.07 Typical High $4.37 | Professional | None | $3.98 | $4.07 | $4.37 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Medcost Setting Facility Modifier None Typical Low $4.68 Median $6.61 Typical High $31.62 | Facility | None | $4.68 | $6.61 | $31.62 |
Medcost Setting Professional Modifier None Typical Low $5.37 Median $8.32 Typical High $30.20 | Professional | None | $5.37 | $8.32 | $30.20 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.57 Typical High $2.95 | Professional | None | $1.91 | $2.57 | $2.95 |
6 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 $1.86 Median $2.34 Typical High $2.34 | Professional | 52 · Reduced service | $1.86 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $0.93 Typical High $0.93 | Professional | 53 · Discontinued | $0.76 | $0.93 | $0.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.82 Median $3.55 Typical High $3.55 | Professional | 54 · Surgery only | $2.82 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.71 Typical High $0.71 | Professional | 55 · Aftercare only | $0.56 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.38 Median $0.47 Typical High $0.47 | Professional | 56 · Pre-op care only | $0.38 | $0.47 | $0.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.89 Median $4.37 Typical High $15.14 | Professional | 51 · Multiple procedures | $3.89 | $4.37 | $15.14 |
Where North Carolina sits
The same service costs 3.8 times more in Rhode Island than in New York. 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· 20th of 51
$4.07
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.