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 $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $154.88 | Professional | None | $141.25 | $154.88 | $154.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $177.83 | Professional | None | $141.25 | $177.83 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $131.83 | Professional | None | $87.10 | $87.10 | $131.83 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $213.80 | Facility | None | $154.88 | $154.88 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $123.03 Typical High $131.83 | Professional | None | $117.49 | $123.03 | $131.83 |
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 $58.88 Typical High $89.13 | Professional | None | $15.14 | $58.88 | $89.13 |
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 $70.79 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $70.79 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $28.18 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $21.38 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $14.13 | $15.49 | $15.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $58.88 Median $61.66 Typical High $66.07 | Professional | 51 · Multiple procedures | $58.88 | $61.66 | $66.07 |
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 5.0 times more in Hawaii than in Florida. 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
$162
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.