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 $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $8.51 Typical High $8.51 | Professional | None | $6.03 | $8.51 | $8.51 |
Ambetter Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | None | $4.57 | $4.57 | $4.57 |
BCBS North Carolina Setting Facility Modifier None Typical Low $8.13 Median $10.23 Typical High $13.18 | Facility | None | $8.13 | $10.23 | $13.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $8.32 | Professional | None | $7.41 | $7.41 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.89 Typical High $6.61 | Professional | None | $5.01 | $5.89 | $6.61 |
Medcost Setting Professional Modifier None Typical Low $4.57 Median $4.90 Typical High $6.92 | Professional | None | $4.57 | $4.90 | $6.92 |
Medcost Setting Facility Modifier None Typical Low $2.69 Median $5.37 Typical High $9.33 | Facility | None | $2.69 | $5.37 | $9.33 |
Medcost Setting Professional Modifier None Typical Low $6.03 Median $7.41 Typical High $8.13 | Professional | None | $6.03 | $7.41 | $8.13 |
United Setting Professional Modifier None Typical Low $3.24 Median $4.68 Typical High $6.31 | Professional | None | $3.24 | $4.68 | $6.31 |
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 $0.93 Median $1.29 Typical High $1.29 | Professional | 55 · Aftercare only | $0.93 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.63 Median $0.85 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.63 | $0.85 | $0.85 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.02 Median $3.72 Typical High $10.96 | Professional | 51 · Multiple procedures | $3.02 | $3.72 | $10.96 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | SH · Second concurrent infusion | $3.02 | $3.02 | $3.02 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | SJ · Third+ concurrent infusion | $3.02 | $3.02 | $3.02 |
Where North Carolina sits
The same service costs 2.4 times more in Kansas 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· 19th of 51
$7.41
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.