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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $186.21 | Professional | None | $162.18 | $186.21 | $186.21 |
BCBS North Carolina Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $208.93 | Facility | None | $173.78 | $173.78 | $208.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $218.78 | Professional | None | $169.82 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $158.49 | Professional | None | $104.71 | $104.71 | $158.49 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $257.04 | Facility | None | $186.21 | $186.21 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $158.49 | Professional | None | $141.25 | $147.91 | $158.49 |
United Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $107.15 | Professional | None | $70.79 | $83.18 | $107.15 |
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 $85.11 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $85.11 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $33.88 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $25.12 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $16.98 | $18.62 | $18.62 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $70.79 Median $74.13 Typical High $79.43 | Professional | 51 · Multiple procedures | $70.79 | $74.13 | $79.43 |
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 3.3 times more in Alaska 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· 10th of 51
$195
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.