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 $83.18 Median $93.33 Typical High $114.82 | Facility | None | $83.18 | $93.33 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $117.49 | Professional | None | $83.18 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $44.67 Typical High $57.54 | Professional | 52 · Reduced service | $41.69 | $44.67 | $57.54 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $165.96 | Professional | None | $77.62 | $117.49 | $165.96 |
BCBS South Carolina Setting Facility Modifier None Typical Low $26.92 Median $34.67 Typical High $46.77 | Facility | None | $26.92 | $34.67 | $46.77 |
BCBS South Carolina Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $114.82 | Professional | None | $87.10 | $102.33 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $141.25 | Professional | None | $75.86 | $87.10 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $102.33 Median $125.89 Typical High $223.87 | Professional | None | $102.33 | $125.89 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $102.33 Typical High $141.25 | Facility | None | $83.18 | $102.33 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $134.90 | Professional | None | $91.20 | $107.15 | $134.90 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $79.43 Typical High $112.20 | Professional | None | $48.98 | $79.43 | $112.20 |
United Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $125.89 | Professional | None | $64.57 | $91.20 | $125.89 |
6 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 55 · Aftercare only Typical Low $12.30 Median $13.49 Typical High $17.38 | Professional | 55 · Aftercare only | $12.30 | $13.49 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.91 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.32 | $8.91 | $11.48 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $95.50 Median $117.49 Typical High $204.17 | Professional | 25 · Same-day visit | $95.50 | $117.49 | $204.17 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | GC · Resident with teaching physician | $218.78 | $218.78 | $218.78 |
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 $45.71 Median $53.70 Typical High $85.11 | Professional | 51 · Multiple procedures | $45.71 | $53.70 | $85.11 |
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· 40th of 51
$97.72
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.