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 $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $4.37 Typical High $4.37 | Professional | None | $2.82 | $4.37 | $4.37 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4.17 Median $5.01 Typical High $5.25 | Facility | None | $4.17 | $5.01 | $5.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $4.17 | Professional | None | $3.80 | $3.80 | $4.17 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.16 | Facility | None | $3.02 | $3.02 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $3.02 Typical High $3.24 | Professional | None | $2.57 | $3.02 | $3.24 |
Medcost Setting Professional Modifier None Typical Low $2.34 Median $2.51 Typical High $3.63 | Professional | None | $2.34 | $2.51 | $3.63 |
Medcost Setting Facility Modifier None Typical Low $1.38 Median $3.31 Typical High $4.79 | Facility | None | $1.38 | $3.31 | $4.79 |
Medcost Setting Professional Modifier None Typical Low $3.02 Median $3.80 Typical High $5.13 | Professional | None | $3.02 | $3.80 | $5.13 |
United Setting Professional Modifier None Typical Low $1.66 Median $2.40 Typical High $3.16 | Professional | None | $1.66 | $2.40 | $3.16 |
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 $1.62 Median $2.19 Typical High $2.19 | Professional | 52 · Reduced service | $1.62 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.87 Typical High $0.87 | Professional | 53 · Discontinued | $0.65 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.48 Median $0.66 Typical High $0.66 | Professional | 55 · Aftercare only | $0.48 | $0.66 | $0.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.44 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.32 | $0.44 | $0.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.51 Median $1.78 Typical High $5.62 | Professional | 51 · Multiple procedures | $1.51 | $1.78 | $5.62 |
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 2.3 times more in Kansas than in Utah. 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
$3.80
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.