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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $64.57 Typical High $64.57 | Professional | None | $58.88 | $64.57 | $64.57 |
BCBS North Carolina Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $72.44 | Facility | None | $61.66 | $61.66 | $72.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $75.86 | Professional | None | $58.88 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $56.23 | Professional | None | $34.67 | $34.67 | $56.23 |
Medcost Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Facility | None | $64.57 | $64.57 | $89.13 |
Medcost Setting Professional Modifier None Typical Low $48.98 Median $52.48 Typical High $54.95 | Professional | None | $48.98 | $52.48 | $54.95 |
Oscar Health Setting Professional Modifier None Typical Low $34.67 Median $39.81 Typical High $54.95 | Professional | None | $34.67 | $39.81 | $54.95 |
United Setting Professional Modifier None Typical Low $12.88 Median $28.18 Typical High $37.15 | Professional | None | $12.88 | $28.18 | $37.15 |
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 $29.51 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $29.51 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $11.75 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $8.91 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.89 | $6.46 | $6.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $24.55 Median $25.70 Typical High $27.54 | Professional | 51 · Multiple procedures | $24.55 | $25.70 | $27.54 |
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 2.9 times more in Montana than in Nebraska. 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· 6th of 51
$69.18
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.