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 $4.57 Median $7.76 Typical High $9.33 | Facility | None | $4.57 | $7.76 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $8.51 | Professional | None | $4.57 | $4.57 | $8.51 |
Ambetter Setting Professional Modifier None Typical Low $2.88 Median $5.75 Typical High $8.32 | Professional | None | $2.88 | $5.75 | $8.32 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $4.90 Median $6.92 Typical High $8.32 | Professional | QW · Waived lab test | $4.90 | $6.92 | $8.32 |
BCBS South Carolina Setting Facility Modifier None Typical Low $12.88 Median $26.92 Typical High $69.18 | Facility | None | $12.88 | $26.92 | $69.18 |
BCBS South Carolina Setting Professional Modifier None Typical Low $5.01 Median $10.00 Typical High $11.22 | Professional | None | $5.01 | $10.00 | $11.22 |
BCBS South Carolina Setting Professional Modifier QW · Waived lab test Typical Low $5.75 Median $5.75 Typical High $6.17 | Professional | QW · Waived lab test | $5.75 | $5.75 | $6.17 |
Cigna Setting Facility Modifier None Typical Low $10.96 Median $17.38 Typical High $36.31 | Facility | None | $10.96 | $17.38 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $2.63 Median $3.31 Typical High $6.61 | Professional | None | $2.63 | $3.31 | $6.61 |
Medcost Setting Facility Modifier None Typical Low $4.07 Median $5.75 Typical High $30.20 | Facility | None | $4.07 | $5.75 | $30.20 |
Medcost Setting Professional Modifier None Typical Low $3.02 Median $7.94 Typical High $12.02 | Professional | None | $3.02 | $7.94 | $12.02 |
United Setting Facility Modifier None Typical Low $5.25 Median $5.25 Typical High $6.92 | Facility | None | $5.25 | $5.25 | $6.92 |
United Setting Professional Modifier None Typical Low $3.24 Median $4.68 Typical High $6.03 | Professional | None | $3.24 | $4.68 | $6.03 |
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 $2.29 Median $2.29 Typical High $2.34 | Professional | 52 · Reduced service | $2.29 | $2.29 | $2.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.91 Median $0.91 Typical High $0.93 | Professional | 53 · Discontinued | $0.91 | $0.91 | $0.93 |
Where South Carolina sits
The same service costs 7.9 times more in Minnesota than in New York. 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· 5th of 51
$10.00
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.