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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $58.88 | Professional | None | $53.70 | $58.88 | $58.88 |
BCBS North Carolina Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $66.07 | Facility | None | $54.95 | $54.95 | $66.07 |
BCBS North Carolina Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $67.61 | Professional | None | $53.70 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $50.12 | Professional | None | $32.36 | $32.36 | $50.12 |
Medcost Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Facility | None | $58.88 | $58.88 | $81.28 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $46.77 Typical High $50.12 | Professional | None | $44.67 | $46.77 | $50.12 |
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 $33.88 | Professional | None | $10.00 | $25.12 | $33.88 |
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 $26.92 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $26.92 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $10.72 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $8.13 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.37 | $5.89 | $5.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.39 Median $23.44 Typical High $25.12 | Professional | 51 · Multiple procedures | $22.39 | $23.44 | $25.12 |
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 2.7 times more in Hawaii than in Alabama. 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
$61.66
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.