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 $1.26 Median $1.26 Typical High $1.26 | Facility | None | $1.26 | $1.26 | $1.26 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $1.26 Typical High $1.38 | Professional | None | $1.00 | $1.26 | $1.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1.62 Median $1.66 Typical High $1.66 | Professional | None | $1.62 | $1.66 | $1.66 |
Cigna Setting Professional Modifier None Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | None | $0.81 | $0.81 | $0.81 |
Medcost Setting Facility Modifier None Typical Low $1.15 Median $1.26 Typical High $4.47 | Facility | None | $1.15 | $1.26 | $4.47 |
Medcost Setting Professional Modifier None Typical Low $1.20 Median $1.29 Typical High $2.09 | Professional | None | $1.20 | $1.29 | $2.09 |
United Setting Professional Modifier None Typical Low $0.56 Median $0.79 Typical High $1.02 | Professional | None | $0.56 | $0.79 | $1.02 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $1.05 Median $1.05 Typical High $1.05 | Professional | A1 · Dressing, 1 wound | $1.05 | $1.05 | $1.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.60 Median $0.65 Typical High $1.35 | Professional | 51 · Multiple procedures | $0.60 | $0.65 | $1.35 |
Where South Carolina sits
The same service costs 2.6 times more in Hawaii 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· 4th of 51
$1.62
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.