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 $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $16.98 Typical High $16.98 | Professional | None | $15.49 | $16.98 | $16.98 |
BCBS North Carolina Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $19.05 | Facility | None | $15.85 | $15.85 | $19.05 |
BCBS North Carolina Setting Professional Modifier None Typical Low $15.49 Median $19.50 Typical High $19.50 | Professional | None | $15.49 | $19.50 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $14.45 | Professional | None | $9.33 | $9.33 | $14.45 |
Medcost Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $23.44 | Facility | None | $16.98 | $16.98 | $23.44 |
Medcost Setting Professional Modifier None Typical Low $12.88 Median $14.13 Typical High $14.45 | Professional | None | $12.88 | $14.13 | $14.45 |
United Setting Professional Modifier None Typical Low $6.46 Median $7.59 Typical High $9.55 | Professional | None | $6.46 | $7.59 | $9.55 |
6 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 $7.76 Median $8.51 Typical High $8.51 | Professional | 52 · Reduced service | $7.76 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.39 Typical High $3.39 | Professional | 53 · Discontinued | $3.09 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $2.29 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.70 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.55 | $1.70 | $1.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.46 Median $7.08 Typical High $7.24 | Professional | 51 · Multiple procedures | $6.46 | $7.08 | $7.24 |
Oscar Health Setting Professional Modifier PM · Post mortem Typical Low $5.01 Median $5.01 Typical High $30.20 | Professional | PM · Post mortem | $5.01 | $5.01 | $30.20 |
Where North Carolina sits
The same service costs 4.2 times more in Hawaii than in New York. 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
$17.78
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.