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 $11.75 Median $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $11.75 Typical High $11.75 | Professional | None | $8.32 | $11.75 | $11.75 |
BCBS North Carolina Setting Facility Modifier None Typical Low $10.96 Median $13.18 Typical High $14.13 | Facility | None | $10.96 | $13.18 | $14.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $8.71 Median $10.23 Typical High $10.96 | Professional | None | $8.71 | $10.23 | $10.96 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.51 | Facility | None | $8.13 | $8.13 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $6.92 Median $8.13 Typical High $8.71 | Professional | None | $6.92 | $8.13 | $8.71 |
Medcost Setting Professional Modifier None Typical Low $6.31 Median $6.76 Typical High $9.55 | Professional | None | $6.31 | $6.76 | $9.55 |
Medcost Setting Facility Modifier None Typical Low $3.72 Median $7.41 Typical High $12.88 | Facility | None | $3.72 | $7.41 | $12.88 |
Medcost Setting Professional Modifier None Typical Low $8.91 Median $10.00 Typical High $12.88 | Professional | None | $8.91 | $10.00 | $12.88 |
United Setting Professional Modifier None Typical Low $4.47 Median $6.31 Typical High $8.51 | Professional | None | $4.47 | $6.31 | $8.51 |
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 $1.29 Median $1.78 Typical High $1.78 | Professional | 55 · Aftercare only | $1.29 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $1.17 Typical High $1.17 | Professional | 56 · Pre-op care only | $0.85 | $1.17 | $1.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4.47 Median $5.01 Typical High $15.14 | Professional | 51 · Multiple procedures | $4.47 | $5.01 | $15.14 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | SH · Second concurrent infusion | $4.47 | $4.47 | $4.47 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | SJ · Third+ concurrent infusion | $4.47 | $4.47 | $4.47 |
Where North Carolina sits
The same service costs 2.1 times more in Hawaii than in Colorado. 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· 19th of 51
$10.23
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.