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 $1.66 Median $1.66 Typical High $1.66 | Facility | None | $1.66 | $1.66 | $1.66 |
Aetna Setting Professional Modifier None Typical Low $0.83 Median $1.66 Typical High $1.66 | Professional | None | $0.83 | $1.66 | $1.66 |
Ambetter Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1.58 Median $1.91 Typical High $2.00 | Facility | None | $1.58 | $1.91 | $2.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1.41 Median $1.45 Typical High $1.58 | Professional | None | $1.41 | $1.45 | $1.58 |
Cigna Setting Facility Modifier None Typical Low $0.72 Median $1.35 Typical High $1.35 | Facility | None | $0.72 | $1.35 | $1.35 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.35 Typical High $1.51 | Professional | None | $1.12 | $1.35 | $1.51 |
Medcost Setting Professional Modifier None Typical Low $1.05 Median $1.12 Typical High $1.58 | Professional | None | $1.05 | $1.12 | $1.58 |
Medcost Setting Facility Modifier None Typical Low $0.62 Median $1.05 Typical High $1.82 | Facility | None | $0.62 | $1.05 | $1.82 |
Medcost Setting Professional Modifier None Typical Low $1.00 Median $1.45 Typical High $2.75 | Professional | None | $1.00 | $1.45 | $2.75 |
United Setting Professional Modifier None Typical Low $0.72 Median $0.93 Typical High $1.29 | Professional | None | $0.72 | $0.93 | $1.29 |
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 $0.21 Median $0.25 Typical High $0.25 | Professional | 55 · Aftercare only | $0.21 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.14 | $0.17 | $0.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.50 Median $0.72 Typical High $2.14 | Professional | 51 · Multiple procedures | $0.50 | $0.72 | $2.14 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | SH · Second concurrent infusion | $0.50 | $0.50 | $0.50 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | SJ · Third+ concurrent infusion | $0.50 | $0.50 | $0.50 |
Where North Carolina sits
The same service costs 5.8 times more in Hawaii than in Rhode Island. 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
$1.45
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.