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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $77.62 Typical High $77.62 | Professional | None | $67.61 | $77.62 | $77.62 |
BCBS North Carolina Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $89.13 | Professional | None | $70.79 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $66.07 | Professional | None | $39.81 | $39.81 | $66.07 |
Medcost Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $107.15 | Facility | None | $77.62 | $77.62 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $61.66 Typical High $66.07 | Professional | None | $58.88 | $61.66 | $66.07 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $64.57 | Professional | None | $50.12 | $50.12 | $64.57 |
United Setting Professional Modifier None Typical Low $15.14 Median $33.88 Typical High $44.67 | Professional | None | $15.14 | $33.88 | $44.67 |
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 $33.11 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $33.11 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $13.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $10.00 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.76 | $7.76 | $7.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $29.51 Median $30.90 Typical High $33.11 | Professional | 51 · Multiple procedures | $29.51 | $30.90 | $33.11 |
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 Ohio. 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· 5th of 51
$81.28
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.