How much rates vary
Facilitymedian $12 · 10th to 90th $11 to $14Professionalmedian $11 · 10th to 90th $8 to $18
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 $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $7.24 Median $12.02 Typical High $14.45 | Professional | None | $7.24 | $12.02 | $14.45 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.76 Median $1.20 Typical High $1.20 | Professional | RR · Rental | $0.76 | $1.20 | $1.20 |
Aetna Setting Professional Modifier UE · Used equipment Typical Low $5.50 Median $8.91 Typical High $8.91 | Professional | UE · Used equipment | $5.50 | $8.91 | $8.91 |
Ambetter 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 Professional Modifier RR · Rental Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | RR · Rental | $1.62 | $1.62 | $1.62 |
Cigna Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $14.13 | Facility | None | $10.96 | $10.96 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $14.13 | Professional | None | $10.96 | $10.96 | $14.13 |
Medcost Setting Professional Modifier None Typical Low $10.47 Median $11.22 Typical High $11.22 | Professional | None | $10.47 | $11.22 | $11.22 |
Medcost Setting Facility Modifier None Typical Low $7.24 Median $12.02 Typical High $14.45 | Facility | None | $7.24 | $12.02 | $14.45 |
Medcost Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $17.78 | Professional | None | $10.00 | $10.00 | $17.78 |
Medcost Setting Professional Modifier RR · Rental Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | RR · Rental | $1.86 | $1.86 | $1.86 |
United Setting Professional Modifier None Typical Low $6.61 Median $9.77 Typical High $13.49 | Professional | None | $6.61 | $9.77 | $13.49 |
United Setting Professional Modifier RR · Rental Typical Low $0.66 Median $0.98 Typical High $1.38 | Professional | RR · Rental | $0.66 | $0.98 | $1.38 |
United Setting Professional Modifier UE · Used equipment Typical Low $4.90 Median $7.41 Typical High $10.00 | Professional | UE · Used equipment | $4.90 | $7.41 | $10.00 |
9 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 MS · Maintenance fee Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | MS · Maintenance fee | $1.20 | $1.20 | $1.20 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $15.14 Median $15.14 Typical High $16.98 | Professional | 50 · Both sides | $15.14 | $15.14 | $16.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.01 Median $5.01 Typical High $5.75 | Professional | 51 · Multiple procedures | $5.01 | $5.01 | $5.75 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.00 Median $2.00 Typical High $2.29 | Professional | 80 · Assistant surgeon | $2.00 | $2.00 | $2.29 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.41 Median $1.41 Typical High $1.58 | Professional | 81 · Minimal assistant surgeon | $1.41 | $1.41 | $1.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.41 Median $1.41 Typical High $1.58 | Professional | 82 · Assistant surgeon, no resident | $1.41 | $1.41 | $1.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.41 Median $1.41 Typical High $1.58 | Professional | AS · PA/NP assist | $1.41 | $1.41 | $1.58 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | SH · Second concurrent infusion | $5.01 | $5.01 | $5.01 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | SJ · Third+ concurrent infusion | $5.01 | $5.01 | $5.01 |
Where North Carolina sits
The same service costs 5.0 times more in Hawaii than in New Mexico. 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· 43rd of 51
$10.96
HI $38.90NM $7.76
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.