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 $389.05 Median $389.05 Typical High $501.19 | Facility | None | $389.05 | $389.05 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $501.19 | Professional | None | $389.05 | $389.05 | $501.19 |
BCBS North Carolina Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $512.86 | Facility | None | $426.58 | $426.58 | $512.86 |
BCBS North Carolina Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $457.09 | Professional | None | $389.05 | $407.38 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $630.96 Typical High $831.76 | Facility | None | $549.54 | $630.96 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $436.52 | Professional | None | $389.05 | $389.05 | $436.52 |
Medcost Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $467.74 | Facility | None | $389.05 | $389.05 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $398.11 | Professional | None | $91.20 | $91.20 | $398.11 |
United Setting Professional Modifier None Typical Low $154.88 Median $389.05 Typical High $398.11 | Professional | None | $154.88 | $389.05 | $398.11 |
8 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 $194.98 Median $194.98 Typical High $204.17 | Professional | 52 · Reduced service | $194.98 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $81.28 | Professional | 53 · Discontinued | $77.62 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $61.66 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $40.74 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $40.74 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | JZ · No drug discarded | $389.05 | $389.05 | $389.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $45.71 Median $45.71 Typical High $64.57 | Professional | 51 · Multiple procedures | $45.71 | $45.71 | $64.57 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | SH · Second concurrent infusion | $45.71 | $45.71 | $45.71 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | SJ · Third+ concurrent infusion | $45.71 | $45.71 | $45.71 |
Where North Carolina sits
The same service costs 1.7 times more in Alaska than in Oklahoma. 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· 42nd of 51
$389
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.