How much rates vary
Facilitymedian $126 · 10th to 90th $66 to $355Professionalmedian $85 · 10th to 90th $59 to $145
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 $75.86 Typical High $128.82 | Facility | None | $51.29 | $75.86 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $69.18 Typical High $104.71 | Professional | None | $51.29 | $69.18 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $190.55 | Professional | None | $64.57 | $112.20 | $190.55 |
BCBS South Carolina Setting Facility Modifier None Typical Low $81.28 Median $134.90 Typical High $478.63 | Facility | None | $81.28 | $134.90 | $478.63 |
BCBS South Carolina Setting Professional Modifier None Typical Low $57.54 Median $69.18 Typical High $112.20 | Professional | None | $57.54 | $69.18 | $112.20 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $57.54 Median $69.18 Typical High $112.20 | Professional | 29 | $57.54 | $69.18 | $112.20 |
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 $61.66 Median $85.11 Typical High $123.03 | Professional | None | $61.66 | $85.11 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $208.93 | Professional | None | $93.33 | $114.82 | $208.93 |
Medcost Setting Facility Modifier None Typical Low $69.18 Median $93.33 Typical High $125.89 | Facility | None | $69.18 | $93.33 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $104.71 Typical High $128.82 | Professional | None | $50.12 | $104.71 | $128.82 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $239.88 | Professional | None | $109.65 | $154.88 | $239.88 |
United Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $117.49 | Professional | None | $64.57 | $87.10 | $117.49 |
16 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 $34.67 Median $40.74 Typical High $46.77 | Professional | 52 · Reduced service | $34.67 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.30 Typical High $13.80 | Professional | 55 · Aftercare only | $10.47 | $12.30 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.13 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.92 | $8.13 | $9.33 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $95.50 Median $114.82 Typical High $162.18 | Professional | 25 · Same-day visit | $95.50 | $114.82 | $162.18 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 57 · Decision for surgery | $109.65 | $109.65 | $109.65 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | FS · Shared visit | $97.72 | $97.72 | $97.72 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $107.15 Median $173.78 Typical High $208.93 | Professional | GC · Resident with teaching physician | $107.15 | $173.78 | $208.93 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $128.82 Median $204.17 Typical High $208.93 | Professional | GE · Resident, primary care exception | $128.82 | $204.17 | $208.93 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | SA · Nurse practitioner | $158.49 | $158.49 | $158.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $39.81 Median $52.48 Typical High $79.43 | Professional | 51 · Multiple procedures | $39.81 | $52.48 | $79.43 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.85 Median $20.89 Typical High $31.62 | Professional | 80 · Assistant surgeon | $15.85 | $20.89 | $31.62 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.22 Median $14.79 Typical High $22.39 | Professional | 81 · Minimal assistant surgeon | $11.22 | $14.79 | $22.39 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.22 Median $14.79 Typical High $22.39 | Professional | 82 · Assistant surgeon, no resident | $11.22 | $14.79 | $22.39 |
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 $11.22 Median $14.79 Typical High $22.39 | Professional | AS · PA/NP assist | $11.22 | $14.79 | $22.39 |
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 2.3 times more in Alaska than in Alabama. 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· 45th of 51
$85.11
AK $170AL $74.13
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.