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 $114.82 Median $147.91 Typical High $177.83 | Facility | None | $114.82 | $147.91 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $162.18 | Professional | None | $114.82 | $147.91 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $234.42 | Professional | None | $91.20 | $147.91 | $234.42 |
BCBS South Carolina Setting Facility Modifier None Typical Low $37.15 Median $147.91 Typical High $181.97 | Facility | None | $37.15 | $147.91 | $181.97 |
BCBS South Carolina Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $147.91 | Professional | None | $104.71 | $123.03 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $120.23 Typical High $186.21 | Professional | None | $75.86 | $120.23 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $281.84 | Professional | None | $131.83 | $165.96 | $281.84 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $138.04 Typical High $177.83 | Facility | None | $114.82 | $138.04 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $169.82 | Professional | None | $87.10 | $134.90 | $169.82 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $107.15 Typical High $151.36 | Professional | None | $66.07 | $107.15 | $151.36 |
United Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $162.18 | Professional | None | $89.13 | $117.49 | $162.18 |
7 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 $56.23 Median $58.88 Typical High $72.44 | Professional | 52 · Reduced service | $56.23 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.38 Typical High $21.88 | Professional | 55 · Aftercare only | $16.98 | $17.38 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.75 Typical High $14.79 | Professional | 56 · Pre-op care only | $11.22 | $11.75 | $14.79 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $120.23 Median $147.91 Typical High $269.15 | Professional | 25 · Same-day visit | $120.23 | $147.91 | $269.15 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $141.25 Median $275.42 Typical High $275.42 | Professional | GC · Resident with teaching physician | $141.25 | $275.42 | $275.42 |
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 $45.71 Median $67.61 Typical High $107.15 | Professional | 51 · Multiple procedures | $45.71 | $67.61 | $107.15 |
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· 37th of 51
$129
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.