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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | None | $81.28 | $89.13 | $89.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $102.33 | Professional | None | $81.28 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $74.13 | Professional | None | $46.77 | $46.77 | $74.13 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Facility | None | $89.13 | $89.13 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $67.61 Median $70.79 Typical High $75.86 | Professional | None | $67.61 | $70.79 | $75.86 |
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 $50.12 | Professional | None | $15.14 | $36.31 | $50.12 |
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 $39.81 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $39.81 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $16.22 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $12.02 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.13 | $8.71 | $8.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.88 Median $35.48 Typical High $38.02 | Professional | 51 · Multiple procedures | $33.88 | $35.48 | $38.02 |
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 2.5 times more in Montana than in Missouri. 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· 8th of 51
$93.33
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.