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 $0.07 Median $0.07 Typical High $0.20 | Facility | None | $0.07 | $0.07 | $0.20 |
Aetna Setting Professional Modifier None Typical Low $0.06 Median $0.07 Typical High $0.08 | Professional | None | $0.06 | $0.07 | $0.08 |
Ambetter Setting Professional Modifier None Typical Low $5.01 Median $6.03 Typical High $7.94 | Professional | None | $5.01 | $6.03 | $7.94 |
BCBS South Carolina Setting Facility Modifier None Typical Low $0.06 Median $0.06 Typical High $0.06 | Facility | None | $0.06 | $0.06 | $0.06 |
BCBS South Carolina Setting Professional Modifier None Typical Low $0.06 Median $0.10 Typical High $0.22 | Professional | None | $0.06 | $0.10 | $0.22 |
Cigna Setting Facility Modifier None Typical Low $0.07 Median $0.10 Typical High $0.15 | Facility | None | $0.07 | $0.10 | $0.15 |
Cigna Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.09 | Professional | None | $0.06 | $0.06 | $0.09 |
Medcost Setting Facility Modifier None Typical Low $0.06 Median $0.08 Typical High $0.68 | Facility | None | $0.06 | $0.08 | $0.68 |
Medcost Setting Professional Modifier None Typical Low $0.07 Median $0.47 Typical High $0.52 | Professional | None | $0.07 | $0.47 | $0.52 |
Molina Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | None | $0.05 | $0.05 | $0.05 |
United Setting Professional Modifier None Typical Low $0.03 Median $0.08 Typical High $0.08 | Professional | None | $0.03 | $0.08 | $0.08 |
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 $6.03 Median $7.08 Typical High $7.94 | Professional | JZ · No drug discarded | $6.03 | $7.08 | $7.94 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.23 Median $0.23 Typical High $0.26 | Professional | 51 · Multiple procedures | $0.23 | $0.23 | $0.26 |
Where South Carolina sits
The same service costs 12.0 times more in Oklahoma than in Delaware. 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· 7th of 51
$0.08
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.