How much rates vary
Facilitymedian $56 · 10th to 90th $25 to $257Professionalmedian $40 · 10th to 90th $22 to $68
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 $22.39 Median $34.67 Typical High $51.29 | Facility | None | $22.39 | $34.67 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $34.67 Typical High $48.98 | Professional | None | $22.39 | $34.67 | $48.98 |
Ambetter Setting Professional Modifier None Typical Low $30.20 Median $56.23 Typical High $81.28 | Professional | None | $30.20 | $56.23 | $81.28 |
BCBS South Carolina Setting Facility Modifier None Typical Low $42.66 Median $81.28 Typical High $371.54 | Facility | None | $42.66 | $81.28 | $371.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $25.70 Median $30.90 Typical High $56.23 | Professional | None | $25.70 | $30.90 | $56.23 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $25.70 Median $34.67 Typical High $56.23 | Professional | 29 | $25.70 | $34.67 | $56.23 |
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 $20.89 Median $34.67 Typical High $53.70 | Professional | None | $20.89 | $34.67 | $53.70 |
Medcost Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $104.71 | Professional | None | $36.31 | $45.71 | $104.71 |
Medcost Setting Facility Modifier None Typical Low $29.51 Median $39.81 Typical High $63.10 | Facility | None | $29.51 | $39.81 | $63.10 |
Medcost Setting Professional Modifier None Typical Low $40.74 Median $50.12 Typical High $64.57 | Professional | None | $40.74 | $50.12 | $64.57 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $123.03 | Professional | None | $56.23 | $77.62 | $123.03 |
United Setting Professional Modifier None Typical Low $21.88 Median $35.48 Typical High $53.70 | Professional | None | $21.88 | $35.48 | $53.70 |
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 $14.79 Median $17.78 Typical High $23.44 | Professional | 52 · Reduced service | $14.79 | $17.78 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $5.37 Typical High $6.92 | Professional | 55 · Aftercare only | $4.47 | $5.37 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.55 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.95 | $3.55 | $4.68 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 24 · Unrelated visit after surgery | $56.23 | $56.23 | $56.23 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $45.71 Median $56.23 Typical High $72.44 | Professional | 25 · Same-day visit | $45.71 | $56.23 | $72.44 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $33.11 Median $33.11 Typical High $38.02 | Professional | 93 · Audio-only telehealth | $33.11 | $33.11 | $38.02 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $42.66 Median $42.66 Typical High $104.71 | Professional | GC · Resident with teaching physician | $42.66 | $42.66 | $104.71 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $79.43 Median $79.43 Typical High $104.71 | Professional | GE · Resident, primary care exception | $79.43 | $79.43 | $104.71 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | SA · Nurse practitioner | $32.36 | $32.36 | $32.36 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.95 Median $20.89 Typical High $39.81 | Professional | 51 · Multiple procedures | $19.95 | $20.89 | $39.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.94 Median $8.32 Typical High $16.22 | Professional | 80 · Assistant surgeon | $7.94 | $8.32 | $16.22 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.62 Median $5.89 Typical High $11.22 | Professional | 81 · Minimal assistant surgeon | $5.62 | $5.89 | $11.22 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.62 Median $5.89 Typical High $11.22 | Professional | 82 · Assistant surgeon, no resident | $5.62 | $5.89 | $11.22 |
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 $5.62 Median $5.89 Typical High $11.22 | Professional | AS · PA/NP assist | $5.62 | $5.89 | $11.22 |
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 2.4 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· 39th of 51
$39.81
AK $77.62NJ $32.36
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.