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 $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $6.03 Typical High $6.03 | Professional | None | $4.37 | $6.03 | $6.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $5.75 Median $7.24 Typical High $9.33 | Facility | None | $5.75 | $7.24 | $9.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $4.68 Median $5.25 Typical High $5.62 | Professional | None | $4.68 | $5.25 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $3.16 Median $4.17 Typical High $4.17 | Facility | None | $3.16 | $4.17 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $4.17 Typical High $4.47 | Professional | None | $3.55 | $4.17 | $4.47 |
Medcost Setting Professional Modifier None Typical Low $3.24 Median $3.47 Typical High $4.90 | Professional | None | $3.24 | $3.47 | $4.90 |
Medcost Setting Facility Modifier None Typical Low $1.91 Median $3.80 Typical High $6.61 | Facility | None | $1.91 | $3.80 | $6.61 |
Medcost Setting Professional Modifier None Typical Low $3.98 Median $5.13 Typical High $8.32 | Professional | None | $3.98 | $5.13 | $8.32 |
United Setting Professional Modifier None Typical Low $2.29 Median $3.31 Typical High $4.47 | Professional | None | $2.29 | $3.31 | $4.47 |
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 $0.66 Median $0.89 Typical High $0.89 | Professional | 55 · Aftercare only | $0.66 | $0.89 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.60 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.44 | $0.60 | $0.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.00 Median $2.57 Typical High $7.76 | Professional | 51 · Multiple procedures | $2.00 | $2.57 | $7.76 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | SH · Second concurrent infusion | $2.00 | $2.00 | $2.00 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | SJ · Third+ concurrent infusion | $2.00 | $2.00 | $2.00 |
Where North Carolina sits
The same service costs 2.1 times more in Idaho than in Connecticut. 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
$5.25
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.