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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | None | $60.26 | $66.07 | $66.07 |
BCBS North Carolina Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Facility | None | $63.10 | $63.10 | $75.86 |
BCBS North Carolina Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $77.62 | Professional | None | $61.66 | $77.62 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $60.26 | Professional | None | $35.48 | $35.48 | $60.26 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $91.20 | Facility | None | $66.07 | $66.07 | $91.20 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $53.70 Typical High $57.54 | Professional | None | $50.12 | $53.70 | $57.54 |
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 $28.84 Typical High $38.02 | Professional | None | $12.88 | $28.84 | $38.02 |
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 $30.20 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $30.20 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $12.02 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $9.12 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.03 | $6.61 | $6.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $25.12 Median $26.92 Typical High $28.84 | Professional | 51 · Multiple procedures | $25.12 | $26.92 | $28.84 |
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 Hawaii than in Indiana. 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
$70.79
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.