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 $27.54 Median $27.54 Typical High $74.13 | Facility | None | $27.54 | $27.54 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $45.71 | Professional | None | $27.54 | $27.54 | $45.71 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $48.98 Typical High $54.95 | Professional | None | $41.69 | $48.98 | $54.95 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $29.51 Median $35.48 Typical High $64.57 | Professional | QW · Waived lab test | $29.51 | $35.48 | $64.57 |
BCBS South Carolina Setting Facility Modifier None Typical Low $64.57 Median $117.49 Typical High $234.42 | Facility | None | $64.57 | $117.49 | $234.42 |
BCBS South Carolina Setting Professional Modifier None Typical Low $14.13 Median $48.98 Typical High $50.12 | Professional | None | $14.13 | $48.98 | $50.12 |
BCBS South Carolina Setting Professional Modifier QW · Waived lab test Typical Low $35.48 Median $35.48 Typical High $37.15 | Professional | QW · Waived lab test | $35.48 | $35.48 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $89.13 Typical High $213.80 | Facility | None | $66.07 | $89.13 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $23.44 Typical High $46.77 | Professional | None | $17.78 | $23.44 | $46.77 |
Medcost Setting Facility Modifier None Typical Low $27.54 Median $37.15 Typical High $100.00 | Facility | None | $27.54 | $37.15 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $41.69 Median $60.26 Typical High $72.44 | Professional | None | $41.69 | $60.26 | $72.44 |
United Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $41.69 | Facility | None | $31.62 | $31.62 | $41.69 |
United Setting Professional Modifier None Typical Low $20.89 Median $35.48 Typical High $48.98 | Professional | None | $20.89 | $35.48 | $48.98 |
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 $13.80 Median $13.80 Typical High $14.13 | Professional | 52 · Reduced service | $13.80 | $13.80 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.50 Typical High $5.62 | Professional | 53 · Discontinued | $5.50 | $5.50 | $5.62 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.39 Median $32.36 Typical High $37.15 | Professional | 51 · Multiple procedures | $22.39 | $32.36 | $37.15 |
Where South Carolina sits
The same service costs 3.4 times more in Minnesota 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· 13th of 51
$48.98
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.