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 $3.55 Median $8.71 Typical High $8.71 | Facility | None | $3.55 | $8.71 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $3.16 Median $8.71 Typical High $8.71 | Professional | None | $3.16 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.47 Median $1.32 Typical High $1.32 | Professional | 55 · Aftercare only | $0.47 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.87 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.32 | $0.87 | $0.87 |
BCBS North Carolina Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $9.77 | Facility | None | $8.32 | $8.32 | $9.77 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3.16 Median $10.23 Typical High $10.23 | Professional | None | $3.16 | $10.23 | $10.23 |
Cigna Setting Facility Modifier None Typical Low $3.47 Median $4.57 Typical High $6.46 | Facility | None | $3.47 | $4.57 | $6.46 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $5.37 | Professional | None | $3.09 | $3.09 | $5.37 |
Medcost Setting Facility Modifier None Typical Low $3.63 Median $3.63 Typical High $8.71 | Facility | None | $3.63 | $3.63 | $8.71 |
Medcost Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $5.62 | Professional | None | $2.00 | $2.00 | $5.62 |
United Setting Professional Modifier None Typical Low $1.26 Median $3.16 Typical High $3.24 | Professional | None | $1.26 | $3.16 | $3.24 |
3 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 51 · Multiple procedures | $1.00 | $1.00 | $1.00 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | SH · Second concurrent infusion | $1.00 | $1.00 | $1.00 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | SJ · Third+ concurrent infusion | $1.00 | $1.00 | $1.00 |
Where North Carolina sits
The same service costs 3.5 times more in Oklahoma than in Virginia. 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
$3.16
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.