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 $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $3.55 Typical High $3.55 | Professional | None | $2.51 | $3.55 | $3.55 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3.39 Median $3.98 Typical High $4.27 | Facility | None | $3.39 | $3.98 | $4.27 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3.02 Median $3.09 Typical High $4.17 | Professional | None | $3.02 | $3.09 | $4.17 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $2.19 Typical High $2.57 | Professional | None | $1.91 | $2.19 | $2.57 |
Medcost Setting Professional Modifier None Typical Low $1.82 Median $1.95 Typical High $3.31 | Professional | None | $1.82 | $1.95 | $3.31 |
Medcost Setting Facility Modifier None Typical Low $1.26 Median $2.24 Typical High $3.89 | Facility | None | $1.26 | $2.24 | $3.89 |
Medcost Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $5.75 | Professional | None | $3.02 | $3.02 | $5.75 |
United Setting Professional Modifier None Typical Low $1.51 Median $1.95 Typical High $2.63 | Professional | None | $1.51 | $1.95 | $2.63 |
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 $0.45 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.45 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.30 | $0.36 | $0.36 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.51 Median $1.51 Typical High $4.57 | Professional | 51 · Multiple procedures | $1.51 | $1.51 | $4.57 |
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 2.5 times more in Hawaii than in Vermont. 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· 18th of 51
$3.09
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.