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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $61.66 Typical High $64.57 | Professional | None | $58.88 | $61.66 | $64.57 |
BCBS South Carolina Setting Facility Modifier None Typical Low $74.13 Median $112.20 Typical High $194.98 | Facility | None | $74.13 | $112.20 | $194.98 |
BCBS South Carolina Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $89.13 | Professional | None | $58.88 | $85.11 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $102.33 Typical High $144.54 | Facility | None | $83.18 | $102.33 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $83.18 Typical High $181.97 | Facility | None | $61.66 | $83.18 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $93.33 | Professional | None | $79.43 | $79.43 | $93.33 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $144.54 Typical High $151.36 | Professional | None | $30.20 | $144.54 | $151.36 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $125.89 | Facility | None | $58.88 | $58.88 | $125.89 |
United Setting Professional Modifier None Typical Low $47.86 Median $61.66 Typical High $63.10 | Professional | None | $47.86 | $61.66 | $63.10 |
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 $29.51 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $29.51 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $11.75 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $8.91 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.89 | $6.17 | $6.17 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | JZ · No drug discarded | $64.57 | $64.57 | $64.57 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $39.81 Median $39.81 Typical High $48.98 | Professional | 51 · Multiple procedures | $39.81 | $39.81 | $48.98 |
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· 17th of 51
$63.10
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.