How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $32.36 Median $32.36 Typical High $38.02 | Facility | None | $32.36 | $32.36 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $32.36 Typical High $32.36 | Professional | None | $21.88 | $32.36 | $32.36 |
BCBS North Carolina Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
BCBS North Carolina Setting Professional Modifier None Typical Low $23.99 Median $28.18 Typical High $30.20 | Professional | None | $23.99 | $28.18 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $21.88 Typical High $21.88 | Facility | None | $18.20 | $21.88 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $21.88 Typical High $26.30 | Professional | None | $18.62 | $21.88 | $26.30 |
Medcost Setting Professional Modifier None Typical Low $16.60 Median $17.78 Typical High $26.30 | Professional | None | $16.60 | $17.78 | $26.30 |
Medcost Setting Facility Modifier None Typical Low $10.00 Median $20.42 Typical High $35.48 | Facility | None | $10.00 | $20.42 | $35.48 |
Medcost Setting Professional Modifier None Typical Low $23.99 Median $27.54 Typical High $52.48 | Professional | None | $23.99 | $27.54 | $52.48 |
United Setting Professional Modifier None Typical Low $12.30 Median $17.38 Typical High $23.44 | Professional | None | $12.30 | $17.38 | $23.44 |
5 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 55 · Aftercare only Typical Low $3.55 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $3.55 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.34 | $3.24 | $3.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.02 Median $13.80 Typical High $41.69 | Professional | 51 · Multiple procedures | $12.02 | $13.80 | $41.69 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | SH · Second concurrent infusion | $12.02 | $12.02 | $12.02 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | SJ · Third+ concurrent infusion | $12.02 | $12.02 | $12.02 |
Where North Carolina sits
The same service costs 2.9 times more in Hawaii than in Rhode Island. 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· 17th of 51
$28.18
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.