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 $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $10.47 Typical High $10.47 | Professional | None | $7.59 | $10.47 | $10.47 |
Ambetter Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
BCBS North Carolina Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.77 | Professional | None | $9.12 | $9.12 | $9.77 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.59 | Facility | None | $7.08 | $7.08 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $7.08 Typical High $7.59 | Professional | None | $6.03 | $7.08 | $7.59 |
Medcost Setting Professional Modifier None Typical Low $5.50 Median $6.03 Typical High $8.51 | Professional | None | $5.50 | $6.03 | $8.51 |
Medcost Setting Facility Modifier None Typical Low $3.24 Median $7.76 Typical High $11.48 | Facility | None | $3.24 | $7.76 | $11.48 |
Medcost Setting Professional Modifier None Typical Low $7.94 Median $8.91 Typical High $12.59 | Professional | None | $7.94 | $8.91 | $12.59 |
United Setting Professional Modifier None Typical Low $3.98 Median $5.62 Typical High $7.59 | Professional | None | $3.98 | $5.62 | $7.59 |
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 $3.80 Median $5.25 Typical High $5.25 | Professional | 52 · Reduced service | $3.80 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.51 Median $2.09 Typical High $2.09 | Professional | 53 · Discontinued | $1.51 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.15 Median $1.55 Typical High $1.55 | Professional | 55 · Aftercare only | $1.15 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $1.05 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.78 | $1.05 | $1.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.98 Median $3.98 Typical High $13.49 | Professional | 51 · Multiple procedures | $3.98 | $3.98 | $13.49 |
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 Hawaii 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
$9.12
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.