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 $77.62 Median $77.62 Typical High $112.20 | Facility | None | $77.62 | $77.62 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $112.20 | Professional | None | $77.62 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $41.69 Typical High $56.23 | Professional | 52 · Reduced service | $38.90 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.59 Typical High $16.60 | Professional | 55 · Aftercare only | $11.75 | $12.59 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.51 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.76 | $8.51 | $11.22 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $112.20 | Professional | None | $74.13 | $95.50 | $112.20 |
BCBS South Carolina Setting Facility Modifier None Typical Low $26.92 Median $31.62 Typical High $46.77 | Facility | None | $26.92 | $31.62 | $46.77 |
BCBS South Carolina Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $117.49 | Professional | None | $87.10 | $102.33 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $141.25 | Professional | None | $75.86 | $83.18 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $213.80 | Professional | None | $104.71 | $128.82 | $213.80 |
Medcost Setting Facility Modifier None Typical Low $77.62 Median $102.33 Typical High $134.90 | Facility | None | $77.62 | $102.33 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $107.15 Typical High $128.82 | Professional | None | $50.12 | $107.15 | $128.82 |
Molina Setting Professional Modifier None Typical Low $45.71 Median $74.13 Typical High $117.49 | Professional | None | $45.71 | $74.13 | $117.49 |
United Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $125.89 | Professional | None | $61.66 | $89.13 | $125.89 |
4 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 $95.50 Median $112.20 Typical High $208.93 | Professional | 25 · Same-day visit | $95.50 | $112.20 | $208.93 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | GC · Resident with teaching physician | $208.93 | $208.93 | $208.93 |
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 $25.12 Median $53.70 Typical High $81.28 | Professional | 51 · Multiple procedures | $25.12 | $53.70 | $81.28 |
Where South Carolina sits
The same service costs 2.8 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· 46th of 51
$89.13
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.