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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $85.11 | Professional | None | $79.43 | $85.11 | $85.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $97.72 | Facility | None | $81.28 | $81.28 | $97.72 |
BCBS North Carolina Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $100.00 | Professional | None | $79.43 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $74.13 | Professional | None | $47.86 | $47.86 | $74.13 |
Medcost Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Facility | None | $85.11 | $85.11 | $117.49 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $69.18 Typical High $74.13 | Professional | None | $64.57 | $69.18 | $74.13 |
United Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $48.98 | Professional | None | $32.36 | $38.02 | $48.98 |
9 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 $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $39.81 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $15.85 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $11.75 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.94 | $8.51 | $8.51 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $32.36 Median $34.67 Typical High $36.31 | Professional | 51 · Multiple procedures | $32.36 | $34.67 | $36.31 |
Oscar Health Setting Professional Modifier PL · Progressive lenses Typical Low $60.26 Median $91.20 Typical High $91.20 | Professional | PL · Progressive lenses | $60.26 | $91.20 | $91.20 |
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where North Carolina sits
The same service costs 2.6 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· 14th of 51
$91.20
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.