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 $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $7.94 Typical High $7.94 | Professional | None | $5.75 | $7.94 | $7.94 |
BCBS North Carolina Setting Facility Modifier None Typical Low $7.59 Median $9.12 Typical High $9.55 | Facility | None | $7.59 | $9.12 | $9.55 |
BCBS North Carolina Setting Professional Modifier None Typical Low $6.76 Median $6.92 Typical High $7.59 | Professional | None | $6.76 | $6.92 | $7.59 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.75 | Facility | None | $5.50 | $5.50 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $5.50 Typical High $5.89 | Professional | None | $4.68 | $5.50 | $5.89 |
Medcost Setting Professional Modifier None Typical Low $4.27 Median $4.57 Typical High $6.46 | Professional | None | $4.27 | $4.57 | $6.46 |
Medcost Setting Facility Modifier None Typical Low $2.51 Median $6.03 Typical High $8.71 | Facility | None | $2.51 | $6.03 | $8.71 |
Medcost Setting Professional Modifier None Typical Low $6.03 Median $6.92 Typical High $9.77 | Professional | None | $6.03 | $6.92 | $9.77 |
United Setting Professional Modifier None Typical Low $3.02 Median $4.37 Typical High $5.75 | Professional | None | $3.02 | $4.37 | $5.75 |
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 $2.95 Median $3.98 Typical High $3.98 | Professional | 52 · Reduced service | $2.95 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.17 Median $1.58 Typical High $1.58 | Professional | 53 · Discontinued | $1.17 | $1.58 | $1.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $1.20 Typical High $1.20 | Professional | 55 · Aftercare only | $0.87 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.79 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.59 | $0.79 | $0.79 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.02 Median $3.16 Typical High $10.23 | Professional | 51 · Multiple procedures | $3.02 | $3.16 | $10.23 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | SH · Second concurrent infusion | $3.02 | $3.02 | $3.02 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | SJ · Third+ concurrent infusion | $3.02 | $3.02 | $3.02 |
Where North Carolina sits
The same service costs 2.3 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· 20th of 51
$6.92
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.