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 $11.22 Median $11.22 Typical High $30.20 | Facility | None | $11.22 | $11.22 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $13.80 | Professional | None | $11.22 | $11.22 | $13.80 |
BCBS South Carolina Setting Facility Modifier None Typical Low $35.48 Median $77.62 Typical High $158.49 | Facility | None | $35.48 | $77.62 | $158.49 |
BCBS South Carolina Setting Professional Modifier None Typical Low $14.45 Median $28.18 Typical High $36.31 | Professional | None | $14.45 | $28.18 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $36.31 Typical High $87.10 | Facility | None | $26.92 | $36.31 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $7.24 Median $9.55 Typical High $18.20 | Professional | None | $7.24 | $9.55 | $18.20 |
Medcost Setting Facility Modifier None Typical Low $10.72 Median $15.14 Typical High $104.71 | Facility | None | $10.72 | $15.14 | $104.71 |
Medcost Setting Professional Modifier None Typical Low $15.85 Median $24.55 Typical High $26.92 | Professional | None | $15.85 | $24.55 | $26.92 |
United Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $17.38 | Facility | None | $12.88 | $12.88 | $17.38 |
United Setting Professional Modifier None Typical Low $6.03 Median $9.77 Typical High $19.95 | Professional | None | $6.03 | $9.77 | $19.95 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $5.62 Typical High $5.75 | Professional | 52 · Reduced service | $5.62 | $5.62 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $2.29 | Professional | 53 · Discontinued | $2.24 | $2.24 | $2.29 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 90 · Outside lab | $14.45 | $14.45 | $14.45 |
Where South Carolina sits
The same service costs 4.0 times more in Kansas 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· 3rd of 51
$30.20
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.