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 $89.13 Median $89.13 Typical High $120.23 | Facility | None | $89.13 | $89.13 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | None | $75.86 | $89.13 | $89.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $120.23 | Professional | None | $74.13 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $109.65 Typical High $154.88 | Facility | None | $83.18 | $109.65 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $95.50 | Professional | None | $72.44 | $72.44 | $95.50 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $89.13 | Facility | None | $87.10 | $87.10 | $89.13 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | None | $83.18 | $83.18 | $89.13 |
United Setting Professional Modifier None Typical Low $29.51 Median $74.13 Typical High $89.13 | Professional | None | $29.51 | $74.13 | $89.13 |
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 $38.02 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $38.02 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $15.14 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $11.22 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.59 | $8.91 | $8.91 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 51 · Multiple procedures | $41.69 | $41.69 | $41.69 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | SH · Second concurrent infusion | $41.69 | $41.69 | $41.69 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | SJ · Third+ concurrent infusion | $41.69 | $41.69 | $41.69 |
Where North Carolina sits
The same service costs 1.6 times more in Hawaii than in Delaware. 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· 24th of 51
$74.13
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.