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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $199.53 | Professional | None | $181.97 | $199.53 | $199.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $229.09 | Professional | None | $181.97 | $229.09 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $169.82 | Professional | None | $109.65 | $109.65 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $275.42 | Facility | None | $199.53 | $199.53 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $169.82 | Professional | None | $151.36 | $158.49 | $169.82 |
United Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $112.20 | Professional | None | $75.86 | $89.13 | $112.20 |
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 $91.20 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $91.20 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $36.31 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $27.54 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $18.20 | $19.95 | $19.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $79.43 Typical High $85.11 | Professional | 51 · Multiple procedures | $75.86 | $79.43 | $85.11 |
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 2.5 times more in Alaska 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· 11th of 51
$209
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.