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 $3.31 Median $3.31 Typical High $3.31 | Facility | None | $3.31 | $3.31 | $3.31 |
Aetna Setting Professional Modifier None Typical Low $2.75 Median $3.31 Typical High $3.31 | Professional | None | $2.75 | $3.31 | $3.31 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3.09 Median $3.72 Typical High $3.98 | Facility | None | $3.09 | $3.72 | $3.98 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2.51 Median $2.88 Typical High $3.09 | Professional | None | $2.51 | $2.88 | $3.09 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $3.31 | Facility | None | $2.69 | $2.69 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.69 Typical High $3.24 | Professional | None | $2.29 | $2.69 | $3.24 |
Medcost Setting Professional Modifier None Typical Low $2.09 Median $2.24 Typical High $3.16 | Professional | None | $2.09 | $2.24 | $3.16 |
Medcost Setting Facility Modifier None Typical Low $1.23 Median $2.09 Typical High $3.63 | Facility | None | $1.23 | $2.09 | $3.63 |
Medcost Setting Professional Modifier None Typical Low $2.00 Median $2.82 Typical High $5.37 | Professional | None | $2.00 | $2.82 | $5.37 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.91 Typical High $2.51 | Professional | None | $1.32 | $1.91 | $2.51 |
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 $1.41 Median $1.66 Typical High $1.66 | Professional | 52 · Reduced service | $1.41 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.66 Typical High $0.66 | Professional | 53 · Discontinued | $0.56 | $0.66 | $0.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.50 Typical High $0.50 | Professional | 55 · Aftercare only | $0.42 | $0.50 | $0.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.33 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.28 | $0.33 | $0.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.00 Median $1.41 Typical High $4.27 | Professional | 51 · Multiple procedures | $1.00 | $1.41 | $4.27 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | SH · Second concurrent infusion | $1.00 | $1.00 | $1.00 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | SJ · Third+ concurrent infusion | $1.00 | $1.00 | $1.00 |
Where North Carolina sits
The same service costs 2.1 times more in Montana 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· 23rd of 51
$2.88
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.