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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $61.66 | Professional | None | $56.23 | $61.66 | $61.66 |
BCBS North Carolina Setting Professional Modifier None Typical Low $56.23 Median $72.44 Typical High $72.44 | Professional | None | $56.23 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $51.29 | Professional | None | $33.88 | $33.88 | $51.29 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $85.11 | Facility | None | $61.66 | $61.66 | $85.11 |
Medcost Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $52.48 | Professional | None | $46.77 | $50.12 | $52.48 |
Oscar Health Setting Professional Modifier None Typical Low $19.95 Median $25.12 Typical High $34.67 | Professional | None | $19.95 | $25.12 | $34.67 |
United Setting Professional Modifier None Typical Low $10.00 Median $25.12 Typical High $35.48 | Professional | None | $10.00 | $25.12 | $35.48 |
8 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 $28.18 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $28.18 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $11.22 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.51 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.62 | $6.17 | $6.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $23.44 Median $25.12 Typical High $26.30 | Professional | 51 · Multiple procedures | $23.44 | $25.12 | $26.30 |
Oscar Health Setting Professional Modifier GX · Voluntary liability notice Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | GX · Voluntary liability notice | $15.14 | $15.14 | $15.14 |
Oscar Health Setting Professional Modifier LO Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | LO | $30.20 | $30.20 | $30.20 |
Oscar Health Setting Professional Modifier PL · Progressive lenses Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | PL · Progressive lenses | $15.14 | $15.14 | $15.14 |
Where North Carolina sits
The same service costs 3.1 times more in Montana 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· 10th of 51
$64.57
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.