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 $18.20 Median $18.20 Typical High $22.39 | Facility | None | $18.20 | $18.20 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $18.20 Typical High $18.20 | Professional | None | $17.38 | $18.20 | $18.20 |
BCBS South Carolina Setting Facility Modifier None Typical Low $9.55 Median $17.78 Typical High $35.48 | Facility | None | $9.55 | $17.78 | $35.48 |
BCBS South Carolina Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $18.62 | Professional | None | $17.38 | $17.38 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $30.20 Typical High $42.66 | Facility | None | $23.99 | $30.20 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Medcost Setting Facility Modifier None Typical Low $18.20 Median $21.88 Typical High $46.77 | Facility | None | $18.20 | $21.88 | $46.77 |
Medcost Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $17.38 | Professional | None | $10.23 | $10.23 | $17.38 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $42.66 Typical High $42.66 | Professional | None | $30.20 | $42.66 | $42.66 |
United Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $37.15 | Facility | None | $17.38 | $17.38 | $37.15 |
United Setting Professional Modifier None Typical Low $13.49 Median $16.98 Typical High $18.20 | Professional | None | $13.49 | $16.98 | $18.20 |
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 $8.51 Median $9.12 Typical High $9.12 | Professional | 52 · Reduced service | $8.51 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.63 Typical High $3.63 | Professional | 53 · Discontinued | $3.47 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.57 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.74 | $1.82 | $1.82 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | JZ · No drug discarded | $19.05 | $19.05 | $19.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.13 Median $5.13 Typical High $10.72 | Professional | 51 · Multiple procedures | $5.13 | $5.13 | $10.72 |
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· 19th of 51
$17.38
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.