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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $81.28 | Professional | None | $75.86 | $81.28 | $81.28 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
BCBS South Carolina Setting Facility Modifier None Typical Low $57.54 Median $91.20 Typical High $162.18 | Facility | None | $57.54 | $91.20 | $162.18 |
BCBS South Carolina Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $87.10 | Professional | None | $75.86 | $81.28 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $134.90 Typical High $186.21 | Facility | None | $107.15 | $134.90 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Medcost Setting Facility Modifier None Typical Low $81.28 Median $95.50 Typical High $204.17 | Facility | None | $81.28 | $95.50 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $87.10 | Professional | None | $53.70 | $53.70 | $87.10 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $190.55 Typical High $190.55 | Professional | None | $30.20 | $190.55 | $190.55 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $165.96 | Facility | None | $75.86 | $75.86 | $165.96 |
United Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $79.43 | Professional | None | $60.26 | $77.62 | $79.43 |
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 $38.02 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $38.02 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $15.14 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $60.26 Typical High $60.26 | Professional | 54 · Surgery only | $57.54 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $11.48 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.59 | $7.94 | $7.94 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | JW · Drug discarded | $75.86 | $75.86 | $75.86 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.92 Median $26.92 Typical High $50.12 | Professional | 51 · Multiple procedures | $26.92 | $26.92 | $50.12 |
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· 13th of 51
$79.43
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.