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 $51.29 Median $83.18 Typical High $10,000.00 | Facility | None | $51.29 | $83.18 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $102.33 | Professional | None | $51.29 | $72.44 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $64.57 Typical High $100.00 | Professional | None | $32.36 | $64.57 | $100.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $239.88 Median $707.95 Typical High $1,148.15 | Facility | None | $239.88 | $707.95 | $1,148.15 |
BCBS South Carolina Setting Professional Modifier None Typical Low $38.02 Median $61.66 Typical High $83.18 | Professional | None | $38.02 | $61.66 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $97.72 Typical High $707.95 | Facility | None | $43.65 | $97.72 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $77.62 Typical High $102.33 | Professional | None | $57.54 | $77.62 | $102.33 |
Medcost Setting Facility Modifier None Typical Low $44.67 Median $56.23 Typical High $81.28 | Facility | None | $44.67 | $56.23 | $81.28 |
Medcost Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $128.82 | Professional | None | $74.13 | $91.20 | $128.82 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $117.49 | Professional | None | $64.57 | $79.43 | $117.49 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $40.74 Median $58.88 Typical High $104.71 | Professional | None | $40.74 | $58.88 | $104.71 |
8 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 $25.70 Median $27.54 Typical High $37.15 | Professional | 52 · Reduced service | $25.70 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.96 Typical High $14.79 | Professional | 53 · Discontinued | $10.23 | $10.96 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $40.74 Typical High $54.95 | Professional | 54 · Surgery only | $38.90 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.32 Typical High $10.96 | Professional | 55 · Aftercare only | $7.76 | $8.32 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.62 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.13 | $5.62 | $7.41 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $83.18 Median $104.71 Typical High $151.36 | Professional | 50 · Both sides | $83.18 | $104.71 | $151.36 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $138.04 Typical High $194.98 | Professional | 50 · Both sides | $114.82 | $138.04 | $194.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $38.90 Median $45.71 Typical High $64.57 | Professional | 51 · Multiple procedures | $38.90 | $45.71 | $64.57 |
Where South Carolina sits
The same service costs 4.2 times more in Alaska 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· 30th of 51
$70.79
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.