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 $0.11 Median $0.12 Typical High $0.12 | Facility | None | $0.11 | $0.12 | $0.12 |
Aetna Setting Professional Modifier None Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | None | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 52 · Reduced service | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2.88 Median $4.47 Typical High $8.32 | Facility | None | $2.88 | $4.47 | $8.32 |
BCBS South Carolina Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.27 | Professional | None | $0.26 | $0.26 | $0.27 |
Cigna Setting Facility Modifier None Typical Low $0.15 Median $0.25 Typical High $0.32 | Facility | None | $0.15 | $0.25 | $0.32 |
Cigna Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | None | $0.13 | $0.13 | $0.13 |
Medcost Setting Professional Modifier None Typical Low $0.43 Median $0.58 Typical High $6.46 | Professional | None | $0.43 | $0.58 | $6.46 |
Medcost Setting Facility Modifier None Typical Low $0.12 Median $0.14 Typical High $0.16 | Facility | None | $0.12 | $0.14 | $0.16 |
Medcost Setting Professional Modifier None Typical Low $0.04 Median $1.00 Typical High $2.24 | Professional | None | $0.04 | $1.00 | $2.24 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $0.10 Median $0.13 Typical High $0.13 | Professional | None | $0.10 | $0.13 | $0.13 |
1 more rate 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.02 Median $0.50 Typical High $1.38 | Professional | 51 · Multiple procedures | $0.02 | $0.50 | $1.38 |
Where South Carolina sits
The same service costs 32.4 times more in Montana than in Hawaii. 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· 13th of 51
$0.13
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.