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 $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $95.50 Typical High $95.50 | Professional | None | $77.62 | $95.50 | $95.50 |
BCBS North Carolina Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $109.65 | Professional | None | $87.10 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $74.13 | Professional | None | $45.71 | $45.71 | $74.13 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $131.83 | Facility | None | $95.50 | $95.50 | $131.83 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $81.28 | Professional | None | $72.44 | $75.86 | $81.28 |
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 $36.31 Typical High $53.70 | Professional | None | $15.14 | $36.31 | $53.70 |
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 $38.90 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $38.90 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $15.49 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $11.75 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.76 | $9.33 | $9.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $36.31 Median $38.02 Typical High $40.74 | Professional | 51 · Multiple procedures | $36.31 | $38.02 | $40.74 |
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 2.3 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· 3rd of 51
$100
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.