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 $1.38 Median $1.38 Typical High $1.38 | Facility | None | $1.38 | $1.38 | $1.38 |
Aetna Setting Professional Modifier None Typical Low $1.32 Median $1.38 Typical High $1.41 | Professional | None | $1.32 | $1.38 | $1.41 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2.45 Median $5.75 Typical High $6.92 | Facility | None | $2.45 | $5.75 | $6.92 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1.32 Median $3.47 Typical High $4.27 | Professional | None | $1.32 | $3.47 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $1.82 Median $2.29 Typical High $3.16 | Facility | None | $1.82 | $2.29 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Medcost Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Medcost Setting Facility Modifier None Typical Low $1.38 Median $1.86 Typical High $6.03 | Facility | None | $1.38 | $1.86 | $6.03 |
Medcost Setting Professional Modifier None Typical Low $2.04 Median $4.68 Typical High $7.94 | Professional | None | $2.04 | $4.68 | $7.94 |
Molina Setting Professional Modifier None Typical Low $3.39 Median $3.47 Typical High $4.37 | Professional | None | $3.39 | $3.47 | $4.37 |
United Setting Professional Modifier None Typical Low $1.07 Median $1.35 Typical High $1.41 | Professional | None | $1.07 | $1.35 | $1.41 |
6 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 $0.68 Median $0.69 Typical High $0.69 | Professional | 52 · Reduced service | $0.68 | $0.69 | $0.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 53 · Discontinued | $0.27 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
Ambetter Setting Professional Modifier JW · Drug discarded + JZ · No drug discarded Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | JW · Drug discarded + JZ · No drug discarded | $1.32 | $1.32 | $1.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.29 Median $2.19 Typical High $3.98 | Professional | 51 · Multiple procedures | $1.29 | $2.19 | $3.98 |
Where South Carolina sits
The same service costs 1.9 times more in Wyoming than in Florida. 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
$1.41
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.