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 $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $7.59 Typical High $7.59 | Professional | None | $5.37 | $7.59 | $7.59 |
Ambetter Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
BCBS North Carolina Setting Facility Modifier None Typical Low $7.24 Median $8.71 Typical High $9.12 | Facility | None | $7.24 | $8.71 | $9.12 |
BCBS North Carolina Setting Professional Modifier None Typical Low $6.61 Median $6.76 Typical High $7.41 | Professional | None | $6.61 | $6.76 | $7.41 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.61 | Facility | None | $6.17 | $6.17 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $6.17 Typical High $7.08 | Professional | None | $5.25 | $6.17 | $7.08 |
Medcost Setting Professional Modifier None Typical Low $4.27 Median $4.68 Typical High $7.41 | Professional | None | $4.27 | $4.68 | $7.41 |
Medcost Setting Facility Modifier None Typical Low $2.82 Median $5.75 Typical High $8.51 | Facility | None | $2.82 | $5.75 | $8.51 |
Medcost Setting Professional Modifier None Typical Low $6.03 Median $6.61 Typical High $10.47 | Professional | None | $6.03 | $6.61 | $10.47 |
United Setting Professional Modifier None Typical Low $3.31 Median $4.37 Typical High $5.89 | Professional | None | $3.31 | $4.37 | $5.89 |
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 $1.00 Median $1.15 Typical High $1.15 | Professional | 55 · Aftercare only | $1.00 | $1.15 | $1.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.66 Median $0.78 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.66 | $0.78 | $0.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.02 Median $3.31 Typical High $9.77 | Professional | 51 · Multiple procedures | $3.02 | $3.31 | $9.77 |
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 2.1 times more in Hawaii 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· 23rd of 51
$6.76
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.