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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $109.65 | Professional | None | $100.00 | $109.65 | $109.65 |
BCBS North Carolina Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $128.82 | Professional | None | $100.00 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $95.50 | Professional | None | $61.66 | $61.66 | $95.50 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $151.36 | Facility | None | $109.65 | $109.65 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $87.10 Typical High $93.33 | Professional | None | $83.18 | $87.10 | $93.33 |
United Setting Professional Modifier None Typical Low $41.69 Median $48.98 Typical High $63.10 | Professional | None | $41.69 | $48.98 | $63.10 |
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 $50.12 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $50.12 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $20.42 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $15.14 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.23 | $10.96 | $10.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $41.69 Median $43.65 Typical High $46.77 | Professional | 51 · Multiple procedures | $41.69 | $43.65 | $46.77 |
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 Minnesota 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
$115
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.