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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $48.98 Typical High $48.98 | Professional | None | $45.71 | $48.98 | $48.98 |
BCBS North Carolina Setting Professional Modifier None Typical Low $45.71 Median $57.54 Typical High $57.54 | Professional | None | $45.71 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $41.69 | Professional | None | $26.92 | $26.92 | $41.69 |
Medcost Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $67.61 | Facility | None | $48.98 | $48.98 | $67.61 |
Medcost Setting Professional Modifier None Typical Low $37.15 Median $39.81 Typical High $42.66 | Professional | None | $37.15 | $39.81 | $42.66 |
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 $21.38 Typical High $28.18 | Professional | None | $10.00 | $21.38 | $28.18 |
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 $22.39 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $22.39 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $9.12 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $6.76 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.57 | $4.90 | $4.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $18.62 Median $19.95 Typical High $20.89 | Professional | 51 · Multiple procedures | $18.62 | $19.95 | $20.89 |
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 2.6 times more in Hawaii than in Utah. 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
$52.48
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.