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 $0.23 Median $0.24 Typical High $0.72 | Facility | None | $0.23 | $0.24 | $0.72 |
Aetna Setting Professional Modifier None Typical Low $0.24 Median $0.24 Typical High $0.66 | Professional | None | $0.24 | $0.24 | $0.66 |
BCBS North Carolina Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $0.62 | Professional | None | $0.22 | $0.22 | $0.62 |
Cigna Setting Facility Modifier None Typical Low $0.50 Median $0.66 Typical High $0.93 | Facility | None | $0.50 | $0.66 | $0.93 |
Cigna Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.54 | Professional | None | $0.44 | $0.44 | $0.54 |
Medcost Setting Facility Modifier None Typical Low $0.24 Median $0.24 Typical High $0.52 | Facility | None | $0.24 | $0.24 | $0.52 |
Medcost Setting Professional Modifier None Typical Low $0.47 Median $3.02 Typical High $3.02 | Professional | None | $0.47 | $3.02 | $3.02 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.44 Typical High $0.52 | Professional | None | $0.18 | $0.44 | $0.52 |
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 $0.12 Median $0.12 Typical High $0.24 | Professional | 52 · Reduced service | $0.12 | $0.12 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.05 Median $0.05 Typical High $0.09 | Professional | 53 · Discontinued | $0.05 | $0.05 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.04 Typical High $0.07 | Professional | 55 · Aftercare only | $0.04 | $0.04 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.41 Median $1.51 Typical High $1.51 | Professional | 51 · Multiple procedures | $1.41 | $1.51 | $1.51 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | SH · Second concurrent infusion | $1.51 | $1.51 | $1.51 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | SJ · Third+ concurrent infusion | $1.51 | $1.51 | $1.51 |
Where North Carolina sits
The same service costs 1.6 times more in Alaska than in Montana. 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· 47th of 51
$0.44
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.