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 $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $39.81 Typical High $39.81 | Professional | None | $38.02 | $39.81 | $39.81 |
BCBS South Carolina Setting Facility Modifier None Typical Low $26.92 Median $39.81 Typical High $69.18 | Facility | None | $26.92 | $39.81 | $69.18 |
BCBS South Carolina Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $41.69 | Professional | None | $38.02 | $38.02 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $61.66 Typical High $93.33 | Facility | None | $52.48 | $61.66 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medcost Setting Facility Modifier None Typical Low $39.81 Median $47.86 Typical High $100.00 | Facility | None | $39.81 | $47.86 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $43.65 | Professional | None | $28.18 | $28.18 | $43.65 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $91.20 Typical High $93.33 | Professional | None | $30.20 | $91.20 | $93.33 |
United Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $81.28 | Facility | None | $38.02 | $38.02 | $81.28 |
United Setting Professional Modifier None Typical Low $29.51 Median $37.15 Typical High $38.90 | Professional | None | $29.51 | $37.15 | $38.90 |
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 $18.62 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $18.62 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.59 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $5.62 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.80 | $3.98 | $3.98 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | JW · Drug discarded | $34.67 | $34.67 | $34.67 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.13 Median $14.13 Typical High $24.55 | Professional | 51 · Multiple procedures | $14.13 | $14.13 | $24.55 |
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· 45th of 51
$38.02
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.