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 $1.51 Median $1.51 Typical High $1.51 | Facility | None | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.51 Typical High $1.51 | Professional | None | $1.26 | $1.51 | $1.51 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Facility | None | $1.82 | $1.82 | $1.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1.26 Median $1.32 Typical High $1.78 | Professional | None | $1.26 | $1.32 | $1.78 |
Cigna Setting Facility Modifier None Typical Low $1.20 Median $1.20 Typical High $1.29 | Facility | None | $1.20 | $1.20 | $1.29 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.20 Typical High $1.38 | Professional | None | $1.02 | $1.20 | $1.38 |
Medcost Setting Professional Modifier None Typical Low $0.93 Median $1.00 Typical High $1.32 | Professional | None | $0.93 | $1.00 | $1.32 |
Medcost Setting Facility Modifier None Typical Low $0.55 Median $0.98 Typical High $1.66 | Facility | None | $0.55 | $0.98 | $1.66 |
Medcost Setting Professional Modifier None Typical Low $1.00 Median $1.32 Typical High $2.51 | Professional | None | $1.00 | $1.32 | $2.51 |
United Setting Professional Modifier None Typical Low $0.66 Median $0.85 Typical High $1.15 | Professional | None | $0.66 | $0.85 | $1.15 |
5 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 55 · Aftercare only Typical Low $0.19 Median $0.23 Typical High $0.23 | Professional | 55 · Aftercare only | $0.19 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.13 | $0.15 | $0.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.50 Median $0.66 Typical High $1.95 | Professional | 51 · Multiple procedures | $0.50 | $0.66 | $1.95 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | SH · Second concurrent infusion | $0.50 | $0.50 | $0.50 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | SJ · Third+ concurrent infusion | $0.50 | $0.50 | $0.50 |
Where North Carolina sits
The same service costs 2.1 times more in Kansas than in Kentucky. 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· 24th of 51
$1.32
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.