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 $4.57 Median $4.57 Typical High $4.57 | Facility | None | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $4.57 Typical High $4.57 | Professional | None | $3.39 | $4.57 | $4.57 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4.37 Median $5.50 Typical High $7.08 | Facility | None | $4.37 | $5.50 | $7.08 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $4.47 | Professional | None | $3.98 | $3.98 | $4.47 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $3.55 Typical High $3.72 | Professional | None | $2.95 | $3.55 | $3.72 |
Medcost Setting Professional Modifier None Typical Low $2.45 Median $2.63 Typical High $3.80 | Professional | None | $2.45 | $2.63 | $3.80 |
Medcost Setting Facility Modifier None Typical Low $1.45 Median $3.47 Typical High $5.01 | Facility | None | $1.45 | $3.47 | $5.01 |
Medcost Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $11.22 | Professional | None | $3.02 | $3.98 | $11.22 |
United Setting Professional Modifier None Typical Low $1.74 Median $2.51 Typical High $3.31 | Professional | None | $1.74 | $2.51 | $3.31 |
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 $1.70 Median $2.29 Typical High $2.29 | Professional | 52 · Reduced service | $1.70 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.91 Typical High $0.91 | Professional | 53 · Discontinued | $0.68 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.51 Median $0.69 Typical High $0.69 | Professional | 55 · Aftercare only | $0.51 | $0.69 | $0.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.46 Typical High $0.46 | Professional | 56 · Pre-op care only | $0.34 | $0.46 | $0.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.51 Median $1.86 Typical High $5.89 | Professional | 51 · Multiple procedures | $1.51 | $1.86 | $5.89 |
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 2.6 times more in Kansas than in New Hampshire. 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
$3.98
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.