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 $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $12.02 Typical High $12.02 | Professional | None | $8.71 | $12.02 | $12.02 |
Ambetter Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
BCBS North Carolina Setting Facility Modifier None Typical Low $14.45 Median $18.62 Typical High $18.62 | Facility | None | $14.45 | $18.62 | $18.62 |
BCBS North Carolina Setting Professional Modifier None Typical Low $9.12 Median $10.47 Typical High $11.22 | Professional | None | $9.12 | $10.47 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Facility | None | $8.32 | $8.32 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $8.32 Typical High $8.91 | Professional | None | $7.08 | $8.32 | $8.91 |
Medcost Setting Professional Modifier None Typical Low $6.46 Median $6.92 Typical High $9.77 | Professional | None | $6.46 | $6.92 | $9.77 |
Medcost Setting Facility Modifier None Typical Low $3.80 Median $9.12 Typical High $13.18 | Facility | None | $3.80 | $9.12 | $13.18 |
Medcost Setting Professional Modifier None Typical Low $8.91 Median $10.47 Typical High $12.59 | Professional | None | $8.91 | $10.47 | $12.59 |
United Setting Professional Modifier None Typical Low $4.57 Median $6.61 Typical High $8.71 | Professional | None | $4.57 | $6.61 | $8.71 |
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 $1.32 Median $1.82 Typical High $1.82 | Professional | 55 · Aftercare only | $1.32 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $1.20 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.89 | $1.20 | $1.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4.47 Median $5.13 Typical High $15.49 | Professional | 51 · Multiple procedures | $4.47 | $5.13 | $15.49 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | SH · Second concurrent infusion | $4.47 | $4.47 | $4.47 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | SJ · Third+ concurrent infusion | $4.47 | $4.47 | $4.47 |
Where North Carolina sits
The same service costs 2.1 times more in Idaho than in Delaware. 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
$10.47
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.