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 $1.86 Median $2.29 Typical High $5.01 | Facility | None | $1.86 | $2.29 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $3.31 | Professional | None | $1.86 | $1.86 | $3.31 |
Ambetter Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
BCBS South Carolina Setting Facility Modifier None Typical Low $8.32 Median $17.38 Typical High $38.02 | Facility | None | $8.32 | $17.38 | $38.02 |
BCBS South Carolina Setting Professional Modifier None Typical Low $3.98 Median $6.03 Typical High $8.71 | Professional | None | $3.98 | $6.03 | $8.71 |
BCBS South Carolina Setting Professional Modifier QW · Waived lab test Typical Low $2.34 Median $2.34 Typical High $2.51 | Professional | QW · Waived lab test | $2.34 | $2.34 | $2.51 |
Cigna Setting Facility Modifier None Typical Low $4.47 Median $7.08 Typical High $14.13 | Facility | None | $4.47 | $7.08 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $1.15 Median $1.66 Typical High $3.09 | Professional | None | $1.15 | $1.66 | $3.09 |
Medcost Setting Facility Modifier None Typical Low $1.78 Median $2.51 Typical High $16.98 | Facility | None | $1.78 | $2.51 | $16.98 |
Medcost Setting Professional Modifier None Typical Low $3.02 Median $5.01 Typical High $8.32 | Professional | None | $3.02 | $5.01 | $8.32 |
United Setting Facility Modifier None Typical Low $2.14 Median $2.14 Typical High $2.82 | Facility | None | $2.14 | $2.14 | $2.82 |
United Setting Professional Modifier None Typical Low $1.41 Median $2.29 Typical High $3.31 | Professional | None | $1.41 | $2.29 | $3.31 |
2 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 $0.93 Median $0.93 Typical High $0.95 | Professional | 52 · Reduced service | $0.93 | $0.93 | $0.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.37 Median $0.37 Typical High $0.38 | Professional | 53 · Discontinued | $0.37 | $0.37 | $0.38 |
Where South Carolina sits
The same service costs 17.0 times more in Vermont than in Maryland. 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.
South Carolina· 4th of 51
$6.03
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.