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 $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $10.96 Typical High $10.96 | Professional | None | $7.76 | $10.96 | $10.96 |
BCBS North Carolina Setting Facility Modifier None Typical Low $10.23 Median $12.88 Typical High $16.98 | Facility | None | $10.23 | $12.88 | $16.98 |
BCBS North Carolina Setting Professional Modifier None Typical Low $8.13 Median $9.55 Typical High $10.23 | Professional | None | $8.13 | $9.55 | $10.23 |
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 $5.13 Typical High $5.89 | Professional | None | $5.01 | $5.13 | $5.89 |
Medcost Setting Professional Modifier None Typical Low $5.75 Median $6.31 Typical High $8.71 | Professional | None | $5.75 | $6.31 | $8.71 |
Medcost Setting Facility Modifier None Typical Low $3.39 Median $6.76 Typical High $12.02 | Facility | None | $3.39 | $6.76 | $12.02 |
Medcost Setting Professional Modifier None Typical Low $7.94 Median $9.33 Typical High $17.78 | Professional | None | $7.94 | $9.33 | $17.78 |
United Setting Professional Modifier None Typical Low $4.17 Median $5.89 Typical High $7.94 | Professional | None | $4.17 | $5.89 | $7.94 |
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 $1.20 Median $1.62 Typical High $1.62 | Professional | 55 · Aftercare only | $1.20 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.79 | $1.10 | $1.10 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.98 Median $4.68 Typical High $14.13 | Professional | 51 · Multiple procedures | $3.98 | $4.68 | $14.13 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | SH · Second concurrent infusion | $3.98 | $3.98 | $3.98 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | SJ · Third+ concurrent infusion | $3.98 | $3.98 | $3.98 |
Where North Carolina sits
The same service costs 2.7 times more in Hawaii than in Vermont. 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· 13th of 51
$9.55
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.