How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.26 Median $0.26 Typical High $0.26 | Facility | None | $0.26 | $0.26 | $0.26 |
Aetna Setting Professional Modifier None Typical Low $0.23 Median $0.26 Typical High $0.26 | Professional | None | $0.23 | $0.26 | $0.26 |
BCBS South Carolina Setting Facility Modifier AU · Urologic/ostomy supply + AV · With prosthetic/orthotic Typical Low $0.30 Median $0.33 Typical High $0.33 | Facility | AU · Urologic/ostomy supply + AV · With prosthetic/orthotic | $0.30 | $0.33 | $0.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $0.18 Median $0.22 Typical High $0.24 | Professional | None | $0.18 | $0.22 | $0.24 |
Cigna Setting Facility Modifier None Typical Low $0.19 Median $0.20 Typical High $0.22 | Facility | None | $0.19 | $0.20 | $0.22 |
Cigna Setting Professional Modifier None Typical Low $0.17 Median $0.17 Typical High $0.20 | Professional | None | $0.17 | $0.17 | $0.20 |
Medcost Setting Facility Modifier None Typical Low $0.24 Median $0.27 Typical High $0.40 | Facility | None | $0.24 | $0.27 | $0.40 |
Medcost Setting Professional Modifier None Typical Low $0.27 Median $0.27 Typical High $0.43 | Professional | None | $0.27 | $0.27 | $0.43 |
Molina Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | None | $0.22 | $0.22 | $0.22 |
United Setting Professional Modifier None Typical Low $0.11 Median $0.16 Typical High $0.20 | Professional | None | $0.11 | $0.16 | $0.20 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | AU · Urologic/ostomy supply | $18.20 | $18.20 | $18.20 |
Medcost Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | AV · With prosthetic/orthotic | $0.17 | $0.17 | $0.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.13 Median $0.14 Typical High $0.29 | Professional | 51 · Multiple procedures | $0.13 | $0.14 | $0.29 |
Where South Carolina sits
The same service costs 2.7 times more in Arkansas than in Utah. 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· 27th of 51
$0.22
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.