How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.10 Median $0.10 Typical High $0.10 | Facility | None | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier None Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | None | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 52 · Reduced service | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Cigna Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.47 | Professional | None | $0.38 | $0.38 | $0.47 |
Medcost Setting Facility Modifier None Typical Low $0.10 Median $0.10 Typical High $0.11 | Facility | None | $0.10 | $0.10 | $0.11 |
Medcost Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | None | $0.08 | $0.08 | $0.08 |
United Setting Professional Modifier None Typical Low $0.05 Median $0.13 Typical High $0.17 | Professional | None | $0.05 | $0.13 | $0.17 |
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 $0.04 Median $0.04 Typical High $0.04 | Professional | 51 · Multiple procedures | $0.04 | $0.04 | $0.04 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | SH · Second concurrent infusion | $0.04 | $0.04 | $0.04 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | SJ · Third+ concurrent infusion | $0.04 | $0.04 | $0.04 |
Where North Carolina sits
The same service costs 2.3 times more in Minnesota than in Rhode Island. 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· 49th of 51
$0.10
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.