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 $1.58 Median $1.58 Typical High $1.58 | Facility | None | $1.58 | $1.58 | $1.58 |
Aetna Setting Professional Modifier None Typical Low $1.12 Median $1.58 Typical High $1.58 | Professional | None | $1.12 | $1.58 | $1.58 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Facility | None | $1.91 | $1.91 | $1.91 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1.35 Median $1.38 Typical High $1.51 | Professional | None | $1.35 | $1.38 | $1.51 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
Cigna Setting Professional Modifier None Typical Low $0.93 Median $1.10 Typical High $1.17 | Professional | None | $0.93 | $1.10 | $1.17 |
Medcost Setting Professional Modifier None Typical Low $0.83 Median $0.91 Typical High $1.29 | Professional | None | $0.83 | $0.91 | $1.29 |
Medcost Setting Facility Modifier None Typical Low $0.50 Median $1.29 Typical High $1.82 | Facility | None | $0.50 | $1.29 | $1.82 |
Medcost Setting Professional Modifier None Typical Low $1.00 Median $1.38 Typical High $2.19 | Professional | None | $1.00 | $1.38 | $2.19 |
United Setting Professional Modifier None Typical Low $0.60 Median $0.85 Typical High $1.12 | Professional | None | $0.60 | $0.85 | $1.12 |
7 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 $0.58 Median $0.79 Typical High $0.79 | Professional | 52 · Reduced service | $0.58 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.23 Median $0.32 Typical High $0.32 | Professional | 53 · Discontinued | $0.23 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.24 Typical High $0.24 | Professional | 55 · Aftercare only | $0.17 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.12 | $0.16 | $0.16 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.50 Median $0.68 Typical High $2.04 | Professional | 51 · Multiple procedures | $0.50 | $0.68 | $2.04 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | SH · Second concurrent infusion | $0.50 | $0.50 | $0.50 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | SJ · Third+ concurrent infusion | $0.50 | $0.50 | $0.50 |
Where North Carolina sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 20th of 51
$1.38
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.