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 $7.41 Median $7.41 Typical High $7.41 | Facility | None | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $7.41 Typical High $7.41 | Professional | None | $6.03 | $7.41 | $7.41 |
BCBS North Carolina Setting Professional Modifier None Typical Low $5.50 Median $6.46 Typical High $6.92 | Professional | None | $5.50 | $6.46 | $6.92 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Medcost Setting Facility Modifier None Typical Low $7.41 Median $10.23 Typical High $51.29 | Facility | None | $7.41 | $10.23 | $51.29 |
Medcost Setting Professional Modifier None Typical Low $7.08 Median $13.49 Typical High $14.13 | Professional | None | $7.08 | $13.49 | $14.13 |
United Setting Professional Modifier None Typical Low $2.95 Median $4.07 Typical High $4.57 | Professional | None | $2.95 | $4.07 | $4.57 |
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 $2.95 Median $3.72 Typical High $3.72 | Professional | 52 · Reduced service | $2.95 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.17 Median $1.48 Typical High $1.48 | Professional | 53 · Discontinued | $1.17 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.37 Median $5.50 Typical High $5.50 | Professional | 54 · Surgery only | $4.37 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $1.12 Typical High $1.12 | Professional | 55 · Aftercare only | $0.87 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.74 Typical High $0.74 | Professional | 56 · Pre-op care only | $0.59 | $0.74 | $0.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.47 Median $7.08 Typical High $10.00 | Professional | 51 · Multiple procedures | $3.47 | $7.08 | $10.00 |
Where North Carolina sits
The same service costs 4.1 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· 21st of 51
$6.46
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.