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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $117.49 | Professional | None | $107.15 | $117.49 | $117.49 |
BCBS North Carolina Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $131.83 | Facility | None | $109.65 | $109.65 | $131.83 |
BCBS North Carolina Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $134.90 | Professional | None | $107.15 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $102.33 | Professional | None | $64.57 | $64.57 | $102.33 |
Medcost Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $162.18 | Facility | None | $117.49 | $117.49 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $100.00 | Professional | None | $89.13 | $93.33 | $100.00 |
United Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $66.07 | Professional | None | $44.67 | $52.48 | $66.07 |
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 $53.70 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $53.70 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $21.38 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $16.22 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.72 | $11.75 | $11.75 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $44.67 Median $46.77 Typical High $50.12 | Professional | 51 · Multiple procedures | $44.67 | $46.77 | $50.12 |
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 2.4 times more in Montana 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· 12th of 51
$123
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.