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 $0.32 Median $0.32 Typical High $0.32 | Facility | None | $0.32 | $0.32 | $0.32 |
Aetna Setting Professional Modifier None Typical Low $0.23 Median $0.32 Typical High $0.32 | Professional | None | $0.23 | $0.32 | $0.32 |
Ambetter Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
BCBS North Carolina Setting Facility Modifier None Typical Low $0.28 Median $0.34 Typical High $0.35 | Facility | None | $0.28 | $0.34 | $0.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $0.23 Median $0.25 Typical High $0.33 | Professional | None | $0.23 | $0.25 | $0.33 |
Cigna Setting Facility Modifier None Typical Low $0.19 Median $0.20 Typical High $0.20 | Facility | None | $0.19 | $0.20 | $0.20 |
Cigna Setting Professional Modifier None Typical Low $0.17 Median $0.20 Typical High $0.21 | Professional | None | $0.17 | $0.20 | $0.21 |
Medcost Setting Facility Modifier None Typical Low $0.18 Median $0.24 Typical High $0.33 | Facility | None | $0.18 | $0.24 | $0.33 |
Medcost Setting Professional Modifier None Typical Low $0.27 Median $0.27 Typical High $0.33 | Professional | None | $0.27 | $0.27 | $0.33 |
United Setting Professional Modifier None Typical Low $0.11 Median $0.16 Typical High $0.21 | Professional | None | $0.11 | $0.16 | $0.21 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $22.91 Median $25.12 Typical High $25.12 | Professional | AU · Urologic/ostomy supply | $22.91 | $25.12 | $25.12 |
Medcost Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.14 Median $0.15 Typical High $0.21 | Professional | AU · Urologic/ostomy supply | $0.14 | $0.15 | $0.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.14 Median $0.14 Typical High $0.39 | Professional | 51 · Multiple procedures | $0.14 | $0.14 | $0.39 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $0.13 Median $0.14 Typical High $0.14 | Professional | SH · Second concurrent infusion | $0.13 | $0.14 | $0.14 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $0.13 Median $0.14 Typical High $0.14 | Professional | SJ · Third+ concurrent infusion | $0.13 | $0.14 | $0.14 |
Where North Carolina sits
The same service costs 2.7 times more in Arkansas than in Utah. 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· 17th of 51
$0.25
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.