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 $74.13 Median $74.13 Typical High $107.15 | Facility | None | $74.13 | $74.13 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $107.15 | Professional | None | $74.13 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $39.81 Typical High $53.70 | Professional | 52 · Reduced service | $36.31 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.02 Typical High $15.85 | Professional | 55 · Aftercare only | $10.96 | $12.02 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.94 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.41 | $7.94 | $10.72 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $109.65 Typical High $169.82 | Professional | None | $69.18 | $109.65 | $169.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $26.92 Median $35.48 Typical High $67.61 | Facility | None | $26.92 | $35.48 | $67.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $107.15 | Professional | None | $75.86 | $97.72 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $77.62 Typical High $131.83 | Professional | None | $70.79 | $77.62 | $131.83 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $204.17 | Professional | None | $95.50 | $120.23 | $204.17 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $95.50 Typical High $128.82 | Facility | None | $74.13 | $95.50 | $128.82 |
Medcost Setting Professional Modifier None Typical Low $41.69 Median $100.00 Typical High $123.03 | Professional | None | $41.69 | $100.00 | $123.03 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $69.18 Typical High $102.33 | Professional | None | $42.66 | $69.18 | $102.33 |
United Setting Professional Modifier None Typical Low $54.95 Median $83.18 Typical High $117.49 | Professional | None | $54.95 | $83.18 | $117.49 |
5 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $93.33 Median $141.25 Typical High $199.53 | Professional | 25 · Same-day visit | $93.33 | $141.25 | $199.53 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | EP · Child screening program | $194.98 | $194.98 | $194.98 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | GC · Resident with teaching physician | $199.53 | $199.53 | $199.53 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $34.67 Median $54.95 Typical High $54.95 | Professional | 29 | $34.67 | $54.95 | $54.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $20.89 Median $48.98 Typical High $77.62 | Professional | 51 · Multiple procedures | $20.89 | $48.98 | $77.62 |
Where South Carolina sits
The same service costs 2.9 times more in Alaska than in Washington, DC. 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
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.