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 $0.02 Median $0.03 Typical High $0.68 | Facility | None | $0.02 | $0.03 | $0.68 |
Aetna Setting Professional Modifier None Typical Low $0.03 Median $0.05 Typical High $0.40 | Professional | None | $0.03 | $0.05 | $0.40 |
Ambetter Setting Professional Modifier None Typical Low $5.01 Median $7.94 Typical High $10.00 | Professional | None | $5.01 | $7.94 | $10.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $0.55 | Professional | None | $0.05 | $0.05 | $0.55 |
Cigna Setting Facility Modifier None Typical Low $0.07 Median $0.09 Typical High $0.13 | Facility | None | $0.07 | $0.09 | $0.13 |
Cigna Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.49 | Professional | None | $0.06 | $0.06 | $0.49 |
Medcost Setting Facility Modifier None Typical Low $0.03 Median $0.03 Typical High $0.07 | Facility | None | $0.03 | $0.03 | $0.07 |
Medcost Setting Professional Modifier None Typical Low $0.07 Median $0.47 Typical High $0.47 | Professional | None | $0.07 | $0.47 | $0.47 |
United Setting Professional Modifier None Typical Low $0.03 Median $0.08 Typical High $0.10 | Professional | None | $0.03 | $0.08 | $0.10 |
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 $0.23 Median $0.23 Typical High $0.24 | Professional | 51 · Multiple procedures | $0.23 | $0.23 | $0.24 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | SH · Second concurrent infusion | $0.23 | $0.23 | $0.23 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | SJ · Third+ concurrent infusion | $0.23 | $0.23 | $0.23 |
Where North Carolina sits
The same service costs 12.0 times more in Oklahoma 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· 9th of 51
$0.08
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.