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 $25.12 Median $25.12 Typical High $61.66 | Facility | None | $25.12 | $25.12 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $25.12 Typical High $25.12 | Professional | None | $8.13 | $25.12 | $25.12 |
BCBS North Carolina Setting Facility Modifier None Typical Low $8.13 Median $12.02 Typical High $16.22 | Facility | None | $8.13 | $12.02 | $16.22 |
BCBS North Carolina Setting Professional Modifier None Typical Low $8.13 Median $44.67 Typical High $44.67 | Professional | None | $8.13 | $44.67 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $18.62 Typical High $26.30 | Facility | None | $13.80 | $18.62 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $15.49 | Professional | None | $12.30 | $12.30 | $15.49 |
Medcost Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $25.12 | Facility | None | $14.79 | $14.79 | $25.12 |
Medcost Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $45.71 | Professional | None | $28.84 | $28.84 | $45.71 |
United Setting Professional Modifier None Typical Low $3.09 Median $7.76 Typical High $10.00 | Professional | None | $3.09 | $7.76 | $10.00 |
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 $4.07 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $4.07 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $5.01 Typical High $8.91 | Professional | 53 · Discontinued | $1.62 | $5.01 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $3.80 Typical High $6.61 | Professional | 55 · Aftercare only | $1.23 | $3.80 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $2.51 Typical High $4.47 | Professional | 56 · Pre-op care only | $0.81 | $2.51 | $4.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 51 · Multiple procedures | $14.45 | $14.45 | $14.45 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | SH · Second concurrent infusion | $14.45 | $14.45 | $14.45 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | SJ · Third+ concurrent infusion | $14.45 | $14.45 | $14.45 |
Where North Carolina sits
The same service costs 6.3 times more in Wyoming 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· 41st of 51
$12.30
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.