How much rates vary
Facilitymedian $93 · 10th to 90th $40 to $275Professionalmedian $56 · 10th to 90th $34 to $87
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 $30.20 Median $44.67 Typical High $75.86 | Facility | None | $30.20 | $44.67 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $69.18 | Professional | None | $30.20 | $44.67 | $69.18 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $72.44 Typical High $123.03 | Professional | None | $39.81 | $72.44 | $123.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $70.79 Median $93.33 Typical High $371.54 | Facility | None | $70.79 | $93.33 | $371.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $70.79 | Professional | None | $39.81 | $47.86 | $70.79 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $39.81 Median $52.48 Typical High $72.44 | Professional | 29 | $39.81 | $52.48 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $245.47 | Facility | None | $95.50 | $95.50 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $79.43 | Professional | None | $40.74 | $57.54 | $79.43 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $134.90 | Professional | None | $61.66 | $79.43 | $134.90 |
Medcost Setting Facility Modifier None Typical Low $39.81 Median $60.26 Typical High $83.18 | Facility | None | $39.81 | $60.26 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $83.18 | Professional | None | $50.12 | $70.79 | $83.18 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $77.62 Typical High $123.03 | Professional | None | $57.54 | $77.62 | $123.03 |
United Setting Professional Modifier None Typical Low $42.66 Median $60.26 Typical High $79.43 | Professional | None | $42.66 | $60.26 | $79.43 |
12 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 $19.95 Median $25.70 Typical High $30.20 | Professional | 52 · Reduced service | $19.95 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $8.13 Typical High $8.91 | Professional | 55 · Aftercare only | $6.03 | $8.13 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $5.37 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.98 | $5.37 | $6.03 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $60.26 Median $72.44 Typical High $123.03 | Professional | 25 · Same-day visit | $60.26 | $72.44 | $123.03 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | GE · Resident, primary care exception | $128.82 | $128.82 | $128.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $27.54 Median $36.31 Typical High $51.29 | Professional | 51 · Multiple procedures | $27.54 | $36.31 | $51.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.96 Median $14.45 Typical High $20.42 | Professional | 80 · Assistant surgeon | $10.96 | $14.45 | $20.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.76 Median $10.00 Typical High $14.45 | Professional | 81 · Minimal assistant surgeon | $7.76 | $10.00 | $14.45 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.76 Median $10.00 Typical High $14.45 | Professional | 82 · Assistant surgeon, no resident | $7.76 | $10.00 | $14.45 |
Medcost Setting Professional Modifier 93 · Audio-only telehealth Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 93 · Audio-only telehealth | $50.12 | $50.12 | $50.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.76 Median $10.00 Typical High $14.45 | Professional | AS · PA/NP assist | $7.76 | $10.00 | $14.45 |
Medcost Setting Professional Modifier FQ · Audio-only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | FQ · Audio-only | $50.12 | $50.12 | $50.12 |
Where South Carolina sits
The same service costs 2.2 times more in Alaska 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· 44th of 51
$56.23
AK $107NJ $48.98
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.