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 $66.07 Median $66.07 Typical High $95.50 | Facility | None | $66.07 | $66.07 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $97.72 | Professional | None | $66.07 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $36.31 Typical High $47.86 | Professional | 52 · Reduced service | $33.11 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.72 Typical High $14.45 | Professional | 55 · Aftercare only | $10.00 | $10.72 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.24 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.61 | $7.24 | $9.55 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $177.83 | Professional | None | $63.10 | $77.62 | $177.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $24.55 Median $46.77 Typical High $67.61 | Facility | None | $24.55 | $46.77 | $67.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $85.11 | Professional | None | $66.07 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $109.65 | Professional | None | $63.10 | $69.18 | $109.65 |
Medcost Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $186.21 | Professional | None | $74.13 | $91.20 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $81.28 Typical High $114.82 | Facility | None | $66.07 | $81.28 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $81.28 Typical High $112.20 | Professional | None | $44.67 | $81.28 | $112.20 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $70.79 Typical High $102.33 | Professional | None | $43.65 | $70.79 | $102.33 |
United Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $102.33 | Professional | None | $48.98 | $70.79 | $102.33 |
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 $83.18 Median $97.72 Typical High $107.15 | Professional | 25 · Same-day visit | $83.18 | $97.72 | $107.15 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | EP · Child screening program | $177.83 | $177.83 | $177.83 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | GC · Resident with teaching physician | $181.97 | $181.97 | $181.97 |
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 $22.39 Median $40.74 Typical High $69.18 | Professional | 51 · Multiple procedures | $22.39 | $40.74 | $69.18 |
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· 43rd of 51
$75.86
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.