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 $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier None Typical Low $3.80 Median $5.13 Typical High $5.13 | Professional | None | $3.80 | $5.13 | $5.13 |
BCBS North Carolina Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3.89 Median $4.47 Typical High $4.79 | Professional | None | $3.89 | $4.47 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $3.24 Typical High $3.80 | Professional | None | $2.45 | $3.24 | $3.80 |
Medcost Setting Professional Modifier None Typical Low $2.69 Median $2.95 Typical High $4.17 | Professional | None | $2.69 | $2.95 | $4.17 |
Medcost Setting Facility Modifier None Typical Low $1.58 Median $3.24 Typical High $5.62 | Facility | None | $1.58 | $3.24 | $5.62 |
Medcost Setting Professional Modifier None Typical Low $3.98 Median $4.37 Typical High $7.08 | Professional | None | $3.98 | $4.37 | $7.08 |
United Setting Professional Modifier None Typical Low $1.95 Median $2.75 Typical High $3.72 | Professional | None | $1.95 | $2.75 | $3.72 |
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 $0.56 Median $0.78 Typical High $0.78 | Professional | 55 · Aftercare only | $0.56 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.38 Median $0.51 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.38 | $0.51 | $0.51 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.00 Median $2.19 Typical High $6.61 | Professional | 51 · Multiple procedures | $2.00 | $2.19 | $6.61 |
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 3.2 times more in Kansas than in New Hampshire. 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
$4.47
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.