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 $23.99 Median $23.99 Typical High $38.02 | Facility | None | $23.99 | $23.99 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $32.36 Typical High $38.02 | Professional | None | $23.99 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.02 Median $14.13 Typical High $19.05 | Professional | 52 · Reduced service | $12.02 | $14.13 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $4.27 Typical High $5.62 | Professional | 55 · Aftercare only | $3.55 | $4.27 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.82 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.40 | $2.82 | $3.80 |
Ambetter Setting Professional Modifier None Typical Low $30.90 Median $38.02 Typical High $38.02 | Professional | None | $30.90 | $38.02 | $38.02 |
BCBS South Carolina Setting Facility Modifier None Typical Low $9.77 Median $45.71 Typical High $57.54 | Facility | None | $9.77 | $45.71 | $57.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $33.11 | Professional | None | $25.70 | $25.70 | $33.11 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $25.12 Median $32.36 Typical High $38.90 | Professional | 29 | $25.12 | $32.36 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $33.11 Typical High $44.67 | Professional | None | $21.38 | $33.11 | $44.67 |
Medcost Setting Professional Modifier None Typical Low $38.90 Median $47.86 Typical High $72.44 | Professional | None | $38.90 | $47.86 | $72.44 |
Medcost Setting Facility Modifier None Typical Low $23.99 Median $38.02 Typical High $45.71 | Facility | None | $23.99 | $38.02 | $45.71 |
Medcost Setting Professional Modifier None Typical Low $29.51 Median $43.65 Typical High $51.29 | Professional | None | $29.51 | $43.65 | $51.29 |
Molina Setting Professional Modifier None Typical Low $13.80 Median $22.39 Typical High $35.48 | Professional | None | $13.80 | $22.39 | $35.48 |
United Setting Professional Modifier None Typical Low $20.89 Median $30.20 Typical High $42.66 | Professional | None | $20.89 | $30.20 | $42.66 |
2 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 $32.36 Median $32.36 Typical High $33.88 | Professional | 25 · Same-day visit | $32.36 | $32.36 | $33.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.79 Median $24.55 Typical High $27.54 | Professional | 51 · Multiple procedures | $14.79 | $24.55 | $27.54 |
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· 35th of 51
$32.36
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.