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 $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier None Typical Low $2.75 Median $3.89 Typical High $3.89 | Professional | None | $2.75 | $3.89 | $3.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3.24 Median $3.39 Typical High $4.57 | Professional | None | $3.24 | $3.39 | $4.57 |
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 $3.31 | Professional | None | $2.29 | $2.69 | $3.31 |
Medcost Setting Professional Modifier None Typical Low $2.09 Median $2.24 Typical High $3.09 | Professional | None | $2.09 | $2.24 | $3.09 |
Medcost Setting Facility Modifier None Typical Low $1.23 Median $2.45 Typical High $4.27 | Facility | None | $1.23 | $2.45 | $4.27 |
Medcost Setting Professional Modifier None Typical Low $3.02 Median $3.31 Typical High $4.57 | Professional | None | $3.02 | $3.31 | $4.57 |
United Setting Professional Modifier None Typical Low $1.48 Median $2.09 Typical High $2.82 | Professional | None | $1.48 | $2.09 | $2.82 |
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 $0.42 Median $0.58 Typical High $0.58 | Professional | 55 · Aftercare only | $0.42 | $0.58 | $0.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.39 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.28 | $0.39 | $0.39 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.51 Median $1.66 Typical High $5.01 | Professional | 51 · Multiple procedures | $1.51 | $1.66 | $5.01 |
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 Hawaii than in Connecticut. 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
$3.39
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.