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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $204.17 | Professional | None | $190.55 | $190.55 | $204.17 |
BCBS North Carolina Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $331.13 | Professional | None | $181.97 | $181.97 | $331.13 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $229.09 | Facility | None | $190.55 | $190.55 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 51 · Multiple procedures | $97.72 | $97.72 | $97.72 |
United Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $512.86 | Professional | None | $181.97 | $213.80 | $512.86 |
6 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 $95.50 Median $95.50 Typical High $102.33 | Professional | 52 · Reduced service | $95.50 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $40.74 | Professional | 53 · Discontinued | $38.02 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $30.90 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $20.42 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $20.42 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | SH · Second concurrent infusion | $97.72 | $97.72 | $97.72 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | SJ · Third+ concurrent infusion | $97.72 | $97.72 | $97.72 |
Where North Carolina sits
The same service costs 6.6 times more in Alabama than in New York. 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· 36th of 51
$195
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.