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 $93.33 Median $93.33 Typical High $125.89 | Facility | None | $93.33 | $93.33 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $138.04 | Professional | None | $93.33 | $120.23 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $218.78 | Professional | None | $89.13 | $128.82 | $218.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $48.98 Median $147.91 Typical High $181.97 | Facility | None | $48.98 | $147.91 | $181.97 |
BCBS South Carolina Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $125.89 | Professional | None | $87.10 | $102.33 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $154.88 | Professional | None | $79.43 | $97.72 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $239.88 | Professional | None | $112.20 | $138.04 | $239.88 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $114.82 Typical High $154.88 | Facility | None | $93.33 | $114.82 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $147.91 | Professional | None | $75.86 | $114.82 | $147.91 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $89.13 Typical High $120.23 | Professional | None | $54.95 | $89.13 | $120.23 |
United Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $141.25 | Professional | None | $72.44 | $100.00 | $141.25 |
8 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 $46.77 Median $48.98 Typical High $63.10 | Professional | 52 · Reduced service | $46.77 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.79 Typical High $19.05 | Professional | 55 · Aftercare only | $14.13 | $14.79 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.77 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.33 | $9.77 | $12.59 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $89.13 Median $112.20 Typical High $162.18 | Professional | 25 · Same-day visit | $89.13 | $112.20 | $162.18 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | GC · Resident with teaching physician | $239.88 | $239.88 | $239.88 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | GE · Resident, primary care exception | $181.97 | $181.97 | $181.97 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $54.95 Median $54.95 Typical High $63.10 | Professional | 29 | $54.95 | $54.95 | $63.10 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $37.15 Median $57.54 Typical High $93.33 | Professional | 51 · Multiple procedures | $37.15 | $57.54 | $93.33 |
Where South Carolina sits
The same service costs 2.7 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· 39th of 51
$110
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.