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 $24.55 Median $41.69 Typical High $41.69 | Facility | None | $24.55 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $41.69 Typical High $41.69 | Professional | None | $40.74 | $41.69 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $32.36 Typical High $54.95 | Facility | None | $28.84 | $32.36 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Medcost Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $44.67 | Facility | None | $41.69 | $41.69 | $44.67 |
Medcost Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
United Setting Professional Modifier None Typical Low $28.84 Median $70.79 Typical High $70.79 | Professional | None | $28.84 | $70.79 | $70.79 |
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 $19.95 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $19.95 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $8.13 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $6.03 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $4.07 | $4.17 | $4.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 51 · Multiple procedures | $7.94 | $7.94 | $7.94 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | SH · Second concurrent infusion | $7.94 | $7.94 | $7.94 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | SJ · Third+ concurrent infusion | $7.94 | $7.94 | $7.94 |
Where North Carolina sits
The same service costs 3.1 times more in Wisconsin 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· 30th of 51
$40.74
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.