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 $0.13 Median $0.13 Typical High $0.51 | Facility | None | $0.13 | $0.13 | $0.51 |
Aetna Setting Professional Modifier None Typical Low $0.13 Median $0.20 Typical High $0.39 | Professional | None | $0.13 | $0.20 | $0.39 |
BCBS North Carolina Setting Facility Modifier None Typical Low $0.55 Median $0.55 Typical High $0.66 | Facility | None | $0.55 | $0.55 | $0.66 |
BCBS North Carolina Setting Professional Modifier None Typical Low $0.15 Median $0.15 Typical High $0.46 | Professional | None | $0.15 | $0.15 | $0.46 |
Cigna Setting Facility Modifier None Typical Low $0.23 Median $0.30 Typical High $0.42 | Facility | None | $0.23 | $0.30 | $0.42 |
Cigna Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.41 | Professional | None | $0.20 | $0.20 | $0.41 |
Medcost Setting Facility Modifier None Typical Low $0.13 Median $0.13 Typical High $0.24 | Facility | None | $0.13 | $0.13 | $0.24 |
Medcost Setting Professional Modifier None Typical Low $0.23 Median $2.14 Typical High $2.14 | Professional | None | $0.23 | $2.14 | $2.14 |
United Setting Professional Modifier None Typical Low $0.08 Median $0.21 Typical High $0.25 | Professional | None | $0.08 | $0.21 | $0.25 |
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 $0.07 Median $0.07 Typical High $0.11 | Professional | 52 · Reduced service | $0.07 | $0.07 | $0.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.03 Median $0.03 Typical High $0.04 | Professional | 53 · Discontinued | $0.03 | $0.03 | $0.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.22 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.30 Median $1.07 Typical High $1.07 | Professional | 51 · Multiple procedures | $0.30 | $1.07 | $1.07 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | SH · Second concurrent infusion | $1.07 | $1.07 | $1.07 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | SJ · Third+ concurrent infusion | $1.07 | $1.07 | $1.07 |
Where North Carolina sits
The same service costs 2.3 times more in Oklahoma than in Florida. 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· 17th of 51
$0.21
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.