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 $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $2.40 Median $3.39 Typical High $3.39 | Professional | None | $2.40 | $3.39 | $3.39 |
Ambetter Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2.95 Median $3.02 Typical High $3.16 | Professional | None | $2.95 | $3.02 | $3.16 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.51 | Facility | None | $2.34 | $2.34 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.34 Typical High $2.51 | Professional | None | $2.00 | $2.34 | $2.51 |
Medcost Setting Professional Modifier None Typical Low $1.82 Median $1.95 Typical High $2.75 | Professional | None | $1.82 | $1.95 | $2.75 |
Medcost Setting Facility Modifier None Typical Low $1.07 Median $3.02 Typical High $3.98 | Facility | None | $1.07 | $3.02 | $3.98 |
Medcost Setting Professional Modifier None Typical Low $2.95 Median $3.02 Typical High $4.68 | Professional | None | $2.95 | $3.02 | $4.68 |
United Setting Professional Modifier None Typical Low $1.29 Median $1.86 Typical High $2.45 | Professional | None | $1.29 | $1.86 | $2.45 |
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 $1.26 Median $1.70 Typical High $1.70 | Professional | 52 · Reduced service | $1.26 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.68 Typical High $0.68 | Professional | 53 · Discontinued | $0.50 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.38 Median $0.51 Typical High $0.51 | Professional | 55 · Aftercare only | $0.38 | $0.51 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.34 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.25 | $0.34 | $0.34 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.45 Median $1.51 Typical High $4.37 | Professional | 51 · Multiple procedures | $1.45 | $1.51 | $4.37 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | SH · Second concurrent infusion | $1.51 | $1.51 | $1.51 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | SJ · Third+ concurrent infusion | $1.51 | $1.51 | $1.51 |
Where North Carolina sits
The same service costs 2.2 times more in Kansas 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· 18th of 51
$2.95
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.