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 $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $5.75 Typical High $5.75 | Professional | None | $4.17 | $5.75 | $5.75 |
Ambetter Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
BCBS North Carolina Setting Facility Modifier None Typical Low $6.92 Median $9.12 Typical High $9.12 | Facility | None | $6.92 | $9.12 | $9.12 |
BCBS North Carolina Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.37 | Professional | None | $5.13 | $5.13 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Facility | None | $3.98 | $3.98 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.98 Typical High $4.27 | Professional | None | $3.39 | $3.98 | $4.27 |
Medcost Setting Professional Modifier None Typical Low $3.09 Median $3.31 Typical High $4.79 | Professional | None | $3.09 | $3.31 | $4.79 |
Medcost Setting Facility Modifier None Typical Low $1.82 Median $4.37 Typical High $6.46 | Facility | None | $1.82 | $4.37 | $6.46 |
Medcost Setting Professional Modifier None Typical Low $3.98 Median $4.90 Typical High $6.46 | Professional | None | $3.98 | $4.90 | $6.46 |
United Setting Professional Modifier None Typical Low $2.19 Median $3.16 Typical High $4.17 | Professional | None | $2.19 | $3.16 | $4.17 |
7 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 52 · Reduced service Typical Low $2.14 Median $2.88 Typical High $2.88 | Professional | 52 · Reduced service | $2.14 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $1.15 Typical High $1.15 | Professional | 53 · Discontinued | $0.85 | $1.15 | $1.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.87 Typical High $0.87 | Professional | 55 · Aftercare only | $0.65 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.58 Typical High $0.58 | Professional | 56 · Pre-op care only | $0.43 | $0.58 | $0.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.00 Median $2.24 Typical High $7.59 | Professional | 51 · Multiple procedures | $2.00 | $2.24 | $7.59 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | SH · Second concurrent infusion | $2.00 | $2.00 | $2.00 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | SJ · Third+ concurrent infusion | $2.00 | $2.00 | $2.00 |
Where North Carolina sits
The same service costs 2.1 times more in Kansas than in Alabama. 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
$5.13
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.