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 $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $10.72 Typical High $10.72 | Professional | None | $6.46 | $10.72 | $10.72 |
Ambetter Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
BCBS North Carolina Setting Facility Modifier None Typical Low $10.00 Median $12.88 Typical High $16.60 | Facility | None | $10.00 | $12.88 | $16.60 |
BCBS North Carolina Setting Professional Modifier None Typical Low $7.94 Median $9.33 Typical High $10.00 | Professional | None | $7.94 | $9.33 | $10.00 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $7.76 | Facility | None | $7.41 | $7.41 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $7.41 Typical High $7.94 | Professional | None | $6.31 | $7.41 | $7.94 |
Medcost Setting Professional Modifier None Typical Low $5.75 Median $6.17 Typical High $8.71 | Professional | None | $5.75 | $6.17 | $8.71 |
Medcost Setting Facility Modifier None Typical Low $3.39 Median $8.13 Typical High $11.75 | Facility | None | $3.39 | $8.13 | $11.75 |
Medcost Setting Professional Modifier None Typical Low $7.94 Median $9.12 Typical High $12.30 | Professional | None | $7.94 | $9.12 | $12.30 |
United Setting Professional Modifier None Typical Low $4.07 Median $5.75 Typical High $7.76 | Professional | None | $4.07 | $5.75 | $7.76 |
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 $1.17 Median $1.62 Typical High $1.62 | Professional | 55 · Aftercare only | $1.17 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $1.07 Typical High $1.07 | Professional | 56 · Pre-op care only | $0.79 | $1.07 | $1.07 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.98 Median $4.57 Typical High $13.80 | Professional | 51 · Multiple procedures | $3.98 | $4.57 | $13.80 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | SH · Second concurrent infusion | $3.98 | $3.98 | $3.98 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | SJ · Third+ concurrent infusion | $3.98 | $3.98 | $3.98 |
Where North Carolina sits
The same service costs 2.0 times more in Montana than in Florida. 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
$9.33
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.