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 $0.89 Median $0.89 Typical High $6.03 | Facility | None | $0.89 | $0.89 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $1.62 | Professional | None | $0.89 | $0.89 | $1.62 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1.10 Median $3.09 Typical High $4.90 | Professional | None | $1.10 | $3.09 | $4.90 |
Cigna Setting Facility Modifier None Typical Low $1.23 Median $1.62 Typical High $2.29 | Facility | None | $1.23 | $1.62 | $2.29 |
Cigna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $4.37 | Professional | None | $1.10 | $1.10 | $4.37 |
Medcost Setting Facility Modifier None Typical Low $0.89 Median $0.89 Typical High $1.29 | Facility | None | $0.89 | $0.89 | $1.29 |
Medcost Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $4.07 | Professional | None | $3.98 | $3.98 | $4.07 |
United Setting Professional Modifier None Typical Low $0.44 Median $1.10 Typical High $1.45 | Professional | None | $0.44 | $1.10 | $1.45 |
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 $0.45 Median $0.45 Typical High $0.58 | Professional | 52 · Reduced service | $0.45 | $0.45 | $0.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.18 Median $0.18 Typical High $0.79 | Professional | 53 · Discontinued | $0.18 | $0.18 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.14 Median $0.14 Typical High $0.59 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $0.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 51 · Multiple procedures | $2.00 | $2.00 | $2.00 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | SH · Second concurrent infusion | $2.00 | $2.00 | $2.00 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | SJ · Third+ concurrent infusion | $2.00 | $2.00 | $2.00 |
Where North Carolina sits
The same service costs 4.3 times more in Wyoming 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· 40th of 51
$1.10
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.