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 $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $7.24 Median $10.00 Typical High $10.00 | Professional | None | $7.24 | $10.00 | $10.00 |
BCBS North Carolina Setting Facility Modifier None Typical Low $9.33 Median $11.22 Typical High $12.02 | Facility | None | $9.33 | $11.22 | $12.02 |
BCBS North Carolina Setting Professional Modifier None Typical Low $7.59 Median $8.71 Typical High $9.33 | Professional | None | $7.59 | $8.71 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $7.59 | Facility | None | $6.92 | $6.92 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $5.89 Median $6.92 Typical High $7.59 | Professional | None | $5.89 | $6.92 | $7.59 |
Medcost Setting Professional Modifier None Typical Low $5.37 Median $5.75 Typical High $8.13 | Professional | None | $5.37 | $5.75 | $8.13 |
Medcost Setting Facility Modifier None Typical Low $3.16 Median $6.31 Typical High $10.96 | Facility | None | $3.16 | $6.31 | $10.96 |
Medcost Setting Professional Modifier None Typical Low $6.03 Median $8.51 Typical High $12.30 | Professional | None | $6.03 | $8.51 | $12.30 |
United Setting Professional Modifier None Typical Low $3.80 Median $5.37 Typical High $7.08 | Professional | None | $3.80 | $5.37 | $7.08 |
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 $1.10 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.10 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.74 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.74 | $1.00 | $1.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.02 Median $4.27 Typical High $12.88 | Professional | 51 · Multiple procedures | $3.02 | $4.27 | $12.88 |
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 Idaho 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
$8.71
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.