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 $15.49 Median $15.49 Typical High $15.49 | Facility | None | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $15.49 Typical High $15.49 | Professional | None | $11.48 | $15.49 | $15.49 |
BCBS North Carolina Setting Facility Modifier None Typical Low $14.45 Median $17.38 Typical High $18.20 | Facility | None | $14.45 | $17.38 | $18.20 |
BCBS North Carolina Setting Professional Modifier None Typical Low $10.23 Median $13.49 Typical High $17.78 | Professional | None | $10.23 | $13.49 | $17.78 |
Cigna Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $9.12 Median $10.72 Typical High $12.30 | Professional | None | $9.12 | $10.72 | $12.30 |
Medcost Setting Professional Modifier None Typical Low $8.32 Median $8.91 Typical High $12.88 | Professional | None | $8.32 | $8.91 | $12.88 |
Medcost Setting Facility Modifier None Typical Low $4.90 Median $9.55 Typical High $15.49 | Facility | None | $4.90 | $9.55 | $15.49 |
Medcost Setting Professional Modifier None Typical Low $10.96 Median $13.18 Typical High $22.91 | Professional | None | $10.96 | $13.18 | $22.91 |
United Setting Professional Modifier None Typical Low $5.89 Median $8.32 Typical High $10.96 | Professional | None | $5.89 | $8.32 | $10.96 |
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 $1.70 Median $2.29 Typical High $2.29 | Professional | 55 · Aftercare only | $1.70 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.55 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.12 | $1.55 | $1.55 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.50 Median $6.61 Typical High $19.95 | Professional | 51 · Multiple procedures | $5.50 | $6.61 | $19.95 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | SH · Second concurrent infusion | $5.50 | $5.50 | $5.50 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | SJ · Third+ concurrent infusion | $5.50 | $5.50 | $5.50 |
Where North Carolina sits
The same service costs 2.9 times more in Hawaii than in Rhode Island. 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· 20th of 51
$13.49
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.