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 $1.74 Median $1.74 Typical High $1.74 | Facility | None | $1.74 | $1.74 | $1.74 |
Aetna Setting Professional Modifier None Typical Low $1.45 Median $1.74 Typical High $1.74 | Professional | None | $1.45 | $1.74 | $1.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1.48 Median $1.51 Typical High $1.66 | Professional | None | $1.48 | $1.51 | $1.66 |
Cigna Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.74 | Facility | None | $1.41 | $1.41 | $1.74 |
Cigna Setting Professional Modifier None Typical Low $1.20 Median $1.41 Typical High $1.62 | Professional | None | $1.20 | $1.41 | $1.62 |
Medcost Setting Professional Modifier None Typical Low $1.10 Median $1.17 Typical High $1.55 | Professional | None | $1.10 | $1.17 | $1.55 |
Medcost Setting Facility Modifier None Typical Low $0.65 Median $1.10 Typical High $1.91 | Facility | None | $0.65 | $1.10 | $1.91 |
Medcost Setting Professional Modifier None Typical Low $1.00 Median $1.51 Typical High $2.00 | Professional | None | $1.00 | $1.51 | $2.00 |
United Setting Professional Modifier None Typical Low $0.76 Median $0.98 Typical High $1.35 | Professional | None | $0.76 | $0.98 | $1.35 |
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 $0.23 Median $0.26 Typical High $0.26 | Professional | 55 · Aftercare only | $0.23 | $0.26 | $0.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.15 | $0.17 | $0.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.50 Median $0.76 Typical High $2.24 | Professional | 51 · Multiple procedures | $0.50 | $0.76 | $2.24 |
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 5.4 times more in Kansas than in Kentucky. 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· 26th of 51
$1.51
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.