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 $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $47.86 Typical High $47.86 | Professional | None | $33.11 | $47.86 | $47.86 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
BCBS North Carolina Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $57.54 | Facility | None | $47.86 | $47.86 | $57.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $40.74 Median $41.69 Typical High $44.67 | Professional | None | $40.74 | $41.69 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $35.48 Typical High $38.02 | Professional | None | $25.70 | $35.48 | $38.02 |
Medcost Setting Facility Modifier None Typical Low $35.48 Median $47.86 Typical High $54.95 | Facility | None | $35.48 | $47.86 | $54.95 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $70.79 | Professional | None | $44.67 | $44.67 | $70.79 |
United Setting Professional Modifier None Typical Low $17.78 Median $26.92 Typical High $38.90 | Professional | None | $17.78 | $26.92 | $38.90 |
7 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 52 · Reduced service Typical Low $18.20 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $18.20 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $7.24 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $5.37 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.63 | $4.79 | $4.79 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.39 Median $22.39 Typical High $61.66 | Professional | 51 · Multiple procedures | $22.39 | $22.39 | $61.66 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | SH · Second concurrent infusion | $22.39 | $22.39 | $22.39 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | SJ · Third+ concurrent infusion | $22.39 | $22.39 | $22.39 |
Where North Carolina sits
The same service costs 2.2 times more in Hawaii 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· 18th of 51
$41.69
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.