How much rates vary
Facilitymedian $191 · 10th to 90th $100 to $457Professionalmedian $129 · 10th to 90th $95 to $204
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 $83.18 Median $117.49 Typical High $194.98 | Facility | None | $83.18 | $117.49 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $162.18 | Professional | None | $83.18 | $114.82 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $251.19 | Professional | None | $97.72 | $169.82 | $251.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $141.25 Median $190.55 Typical High $602.56 | Facility | None | $141.25 | $190.55 | $602.56 |
BCBS South Carolina Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $158.49 | Professional | None | $93.33 | $114.82 | $158.49 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $93.33 Median $114.82 Typical High $169.82 | Professional | 29 | $93.33 | $114.82 | $169.82 |
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 $104.71 Median $128.82 Typical High $186.21 | Professional | None | $104.71 | $128.82 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $309.03 | Professional | None | $131.83 | $177.83 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $112.20 Median $138.04 Typical High $190.55 | Facility | None | $112.20 | $138.04 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $151.36 Typical High $190.55 | Professional | None | $50.12 | $151.36 | $190.55 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $302.00 | Professional | None | $144.54 | $194.98 | $302.00 |
United Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $181.97 | Professional | None | $107.15 | $134.90 | $181.97 |
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 $56.23 Median $66.07 Typical High $69.18 | Professional | 52 · Reduced service | $56.23 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.95 Typical High $20.89 | Professional | 55 · Aftercare only | $16.60 | $19.95 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.18 Typical High $13.80 | Professional | 56 · Pre-op care only | $11.22 | $13.18 | $13.80 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $120.23 Median $169.82 Typical High $263.03 | Professional | 25 · Same-day visit | $120.23 | $169.82 | $263.03 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $125.89 Median $186.21 Typical High $239.88 | Professional | 57 · Decision for surgery | $125.89 | $186.21 | $239.88 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $186.21 Median $186.21 Typical High $208.93 | Professional | FS · Shared visit | $186.21 | $186.21 | $208.93 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $114.82 Median $223.87 Typical High $309.03 | Professional | GC · Resident with teaching physician | $114.82 | $223.87 | $309.03 |
Ambetter Setting Professional Modifier PD · Before inpatient admission Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | PD · Before inpatient admission | $239.88 | $239.88 | $239.88 |
Ambetter Setting Professional Modifier TH · Pregnancy care Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | TH · Pregnancy care | $134.90 | $134.90 | $134.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $64.57 Median $81.28 Typical High $120.23 | Professional | 51 · Multiple procedures | $64.57 | $81.28 | $120.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.70 Median $32.36 Typical High $47.86 | Professional | 80 · Assistant surgeon | $25.70 | $32.36 | $47.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.78 Median $22.91 Typical High $33.11 | Professional | 81 · Minimal assistant surgeon | $17.78 | $22.91 | $33.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.78 Median $22.91 Typical High $33.11 | Professional | 82 · Assistant surgeon, no resident | $17.78 | $22.91 | $33.11 |
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 $17.78 Median $22.91 Typical High $33.11 | Professional | AS · PA/NP assist | $17.78 | $22.91 | $33.11 |
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· 44th of 51
$129
AK $263AL $115
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.