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 $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $10.96 Typical High $10.96 | Professional | None | $7.94 | $10.96 | $10.96 |
Ambetter Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
BCBS North Carolina Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $8.32 Median $9.55 Typical High $10.23 | Professional | None | $8.32 | $9.55 | $10.23 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.94 | Facility | None | $7.59 | $7.59 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $7.59 Typical High $8.13 | Professional | None | $6.46 | $7.59 | $8.13 |
Medcost Setting Professional Modifier None Typical Low $5.89 Median $6.31 Typical High $9.12 | Professional | None | $5.89 | $6.31 | $9.12 |
Medcost Setting Facility Modifier None Typical Low $3.47 Median $8.32 Typical High $12.30 | Facility | None | $3.47 | $8.32 | $12.30 |
Medcost Setting Professional Modifier None Typical Low $7.94 Median $9.55 Typical High $14.79 | Professional | None | $7.94 | $9.55 | $14.79 |
United Setting Professional Modifier None Typical Low $4.17 Median $6.03 Typical High $7.94 | Professional | None | $4.17 | $6.03 | $7.94 |
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 $1.23 Median $1.66 Typical High $1.66 | Professional | 55 · Aftercare only | $1.23 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.81 | $1.12 | $1.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.98 Median $4.79 Typical High $14.13 | Professional | 51 · Multiple procedures | $3.98 | $4.79 | $14.13 |
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 2.1 times more in Idaho than in New Jersey. 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
$9.55
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.