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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $60.26 Typical High $60.26 | Professional | None | $57.54 | $60.26 | $60.26 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $38.02 Median $58.88 Typical High $102.33 | Facility | None | $38.02 | $58.88 | $102.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $57.54 Median $66.07 Typical High $70.79 | Professional | None | $57.54 | $66.07 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $100.00 Typical High $141.25 | Facility | None | $81.28 | $100.00 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Medcost Setting Facility Modifier None Typical Low $60.26 Median $72.44 Typical High $147.91 | Facility | None | $60.26 | $72.44 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $66.07 | Professional | None | $45.71 | $45.71 | $66.07 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $138.04 Typical High $141.25 | Professional | None | $30.20 | $138.04 | $141.25 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $123.03 | Facility | None | $57.54 | $57.54 | $123.03 |
United Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $58.88 | Professional | None | $43.65 | $54.95 | $58.88 |
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 52 · Reduced service Typical Low $28.84 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $28.84 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $11.48 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.51 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.75 | $6.03 | $6.03 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | JZ · No drug discarded | $63.10 | $63.10 | $63.10 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.39 Median $22.39 Typical High $35.48 | Professional | 51 · Multiple procedures | $22.39 | $22.39 | $35.48 |
Where South Carolina sits
Rates are fairly even across states for this service. 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· 12th of 51
$58.88
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.