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 $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $3.31 Median $7.08 Typical High $7.08 | Professional | None | $3.31 | $7.08 | $7.08 |
Ambetter Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
BCBS North Carolina Setting Facility Modifier None Typical Low $6.61 Median $8.32 Typical High $10.96 | Facility | None | $6.61 | $8.32 | $10.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $5.25 Median $6.17 Typical High $6.46 | Professional | None | $5.25 | $6.17 | $6.46 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $5.13 | Facility | None | $4.79 | $4.79 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $4.07 Median $4.79 Typical High $5.13 | Professional | None | $4.07 | $4.79 | $5.13 |
Medcost Setting Professional Modifier None Typical Low $3.72 Median $3.98 Typical High $5.75 | Professional | None | $3.72 | $3.98 | $5.75 |
Medcost Setting Facility Modifier None Typical Low $2.19 Median $5.25 Typical High $7.76 | Facility | None | $2.19 | $5.25 | $7.76 |
Medcost Setting Professional Modifier None Typical Low $5.01 Median $6.03 Typical High $7.08 | Professional | None | $5.01 | $6.03 | $7.08 |
United Setting Professional Modifier None Typical Low $2.63 Median $3.80 Typical High $5.01 | Professional | None | $2.63 | $3.80 | $5.01 |
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 $0.78 Median $1.05 Typical High $1.05 | Professional | 55 · Aftercare only | $0.78 | $1.05 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.71 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.52 | $0.71 | $0.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.51 Median $3.02 Typical High $9.12 | Professional | 51 · Multiple procedures | $2.51 | $3.02 | $9.12 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | SH · Second concurrent infusion | $2.51 | $2.51 | $2.51 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | SJ · Third+ concurrent infusion | $2.51 | $2.51 | $2.51 |
Where North Carolina sits
The same service costs 2.3 times more in Kansas than in Utah. 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· 18th of 51
$6.17
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.