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 $1.00 Median $1.00 Typical High $1.00 | Facility | None | $1.00 | $1.00 | $1.00 |
Aetna Setting Professional Modifier None Typical Low $0.98 Median $1.00 Typical High $1.00 | Professional | None | $0.98 | $1.00 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 53 · Discontinued | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.10 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.41 | Professional | None | $1.12 | $1.12 | $1.41 |
Medcost Setting Facility Modifier None Typical Low $1.00 Median $1.00 Typical High $1.07 | Facility | None | $1.00 | $1.00 | $1.07 |
Medcost Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | None | $0.39 | $0.39 | $0.39 |
United Setting Professional Modifier None Typical Low $0.42 Median $1.05 Typical High $1.35 | Professional | None | $0.42 | $1.05 | $1.35 |
4 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 $0.49 Median $0.51 Typical High $0.51 | Professional | 52 · Reduced service | $0.49 | $0.51 | $0.51 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 51 · Multiple procedures | $0.20 | $0.20 | $0.20 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | SH · Second concurrent infusion | $0.20 | $0.20 | $0.20 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | SJ · Third+ concurrent infusion | $0.20 | $0.20 | $0.20 |
Where North Carolina sits
The same service costs 10.0 times more in Kansas 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· 38th of 51
$1.00
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.