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 $4.90 Median $4.90 Typical High $4.90 | Facility | None | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $4.90 Typical High $4.90 | Professional | None | $4.07 | $4.90 | $4.90 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4.57 Median $5.50 Typical High $5.89 | Facility | None | $4.57 | $5.50 | $5.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $4.07 Median $4.27 Typical High $5.75 | Professional | None | $4.07 | $4.27 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.98 Typical High $4.57 | Professional | None | $3.39 | $3.98 | $4.57 |
Medcost Setting Professional Modifier None Typical Low $3.02 Median $3.31 Typical High $3.98 | Professional | None | $3.02 | $3.31 | $3.98 |
Medcost Setting Facility Modifier None Typical Low $1.82 Median $3.09 Typical High $5.37 | Facility | None | $1.82 | $3.09 | $5.37 |
Medcost Setting Professional Modifier None Typical Low $3.98 Median $4.17 Typical High $7.94 | Professional | None | $3.98 | $4.17 | $7.94 |
United Setting Professional Modifier None Typical Low $1.95 Median $2.82 Typical High $3.80 | Professional | None | $1.95 | $2.82 | $3.80 |
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 $0.63 Median $0.74 Typical High $0.74 | Professional | 55 · Aftercare only | $0.63 | $0.74 | $0.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.49 Typical High $0.49 | Professional | 56 · Pre-op care only | $0.42 | $0.49 | $0.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.00 Median $2.09 Typical High $6.31 | Professional | 51 · Multiple procedures | $2.00 | $2.09 | $6.31 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | SH · Second concurrent infusion | $2.00 | $2.00 | $2.00 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | SJ · Third+ concurrent infusion | $2.00 | $2.00 | $2.00 |
Where North Carolina sits
The same service costs 2.2 times more in Minnesota 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· 22nd of 51
$4.27
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.