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 $0.50 Median $0.60 Typical High $0.76 | Facility | None | $0.50 | $0.60 | $0.76 |
Aetna Setting Professional Modifier None Typical Low $0.56 Median $0.60 Typical High $0.79 | Professional | None | $0.56 | $0.60 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
BCBS South Carolina Setting Facility Modifier None Typical Low $0.55 Median $5.89 Typical High $7.59 | Facility | None | $0.55 | $5.89 | $7.59 |
BCBS South Carolina Setting Professional Modifier None Typical Low $0.56 Median $0.71 Typical High $0.72 | Professional | None | $0.56 | $0.71 | $0.72 |
Cigna Setting Facility Modifier None Typical Low $0.78 Median $0.95 Typical High $1.35 | Facility | None | $0.78 | $0.95 | $1.35 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Medcost Setting Facility Modifier None Typical Low $0.60 Median $0.81 Typical High $2.40 | Facility | None | $0.60 | $0.81 | $2.40 |
Medcost Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $2.14 | Professional | None | $1.20 | $1.20 | $2.14 |
United Setting Professional Modifier None Typical Low $0.52 Median $0.65 Typical High $0.69 | Professional | None | $0.52 | $0.65 | $0.69 |
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 JZ · No drug discarded Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | JZ · No drug discarded | $3.02 | $3.02 | $3.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.76 Median $0.76 Typical High $8.71 | Professional | 51 · Multiple procedures | $0.76 | $0.76 | $8.71 |
Where South Carolina sits
The same service costs 1.9 times more in Wyoming than in Oklahoma. 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· 12th of 51
$0.63
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.