How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $0.05 Median $0.06 Typical High $0.11 | Facility | None | $0.05 | $0.06 | $0.11 |
Aetna Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | None | $0.06 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 52 · Reduced service | $0.03 | $0.03 | $0.03 |
Ambetter Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
BCBS South Carolina Setting Facility Modifier None Typical Low $0.34 Median $1.55 Typical High $5.89 | Facility | None | $0.34 | $1.55 | $5.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $0.06 Median $0.07 Typical High $0.18 | Professional | None | $0.06 | $0.07 | $0.18 |
Cigna Setting Facility Modifier None Typical Low $0.08 Median $0.10 Typical High $0.15 | Facility | None | $0.08 | $0.10 | $0.15 |
Cigna Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | None | $0.06 | $0.06 | $0.06 |
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 $0.06 Median $0.08 Typical High $0.65 | Facility | None | $0.06 | $0.08 | $0.65 |
Medcost Setting Professional Modifier None Typical Low $0.10 Median $0.30 Typical High $7.59 | Professional | None | $0.10 | $0.30 | $7.59 |
Molina Setting Professional Modifier None Typical Low $0.13 Median $0.15 Typical High $0.20 | Professional | None | $0.13 | $0.15 | $0.20 |
United Setting Professional Modifier None Typical Low $0.06 Median $0.08 Typical High $0.08 | Professional | None | $0.06 | $0.08 | $0.08 |
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 JW · Drug discarded Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | JW · Drug discarded | $7.08 | $7.08 | $7.08 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | JZ · No drug discarded | $6.03 | $6.03 | $6.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.06 Median $3.80 Typical High $5.50 | Professional | 51 · Multiple procedures | $0.06 | $3.80 | $5.50 |
Where South Carolina sits
The same service costs 8.5 times more in Wyoming than in New Jersey. 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· 20th of 51
$0.07
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.