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 $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $18.20 Typical High $18.20 | Professional | None | $13.49 | $18.20 | $18.20 |
BCBS North Carolina Setting Facility Modifier None Typical Low $21.88 Median $28.18 Typical High $28.18 | Facility | None | $21.88 | $28.18 | $28.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $13.80 Median $16.22 Typical High $16.98 | Professional | None | $13.80 | $16.22 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $11.75 Typical High $13.80 | Professional | None | $8.71 | $11.75 | $13.80 |
Medcost Setting Professional Modifier None Typical Low $9.77 Median $10.47 Typical High $15.14 | Professional | None | $9.77 | $10.47 | $15.14 |
Medcost Setting Facility Modifier None Typical Low $5.75 Median $11.48 Typical High $20.42 | Facility | None | $5.75 | $11.48 | $20.42 |
Medcost Setting Professional Modifier None Typical Low $14.13 Median $15.85 Typical High $25.12 | Professional | None | $14.13 | $15.85 | $25.12 |
United Setting Professional Modifier None Typical Low $6.92 Median $10.00 Typical High $13.18 | Professional | None | $6.92 | $10.00 | $13.18 |
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 $2.04 Median $2.75 Typical High $2.75 | Professional | 55 · Aftercare only | $2.04 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.35 | $1.82 | $1.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $7.08 Median $7.94 Typical High $23.44 | Professional | 51 · Multiple procedures | $7.08 | $7.94 | $23.44 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | SH · Second concurrent infusion | $7.08 | $7.08 | $7.08 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | SJ · Third+ concurrent infusion | $7.08 | $7.08 | $7.08 |
Where North Carolina sits
The same service costs 2.3 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· 16th of 51
$16.22
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.