How much rates vary
Facilitymedian $562 · 10th to 90th $72 to $1,549Professionalmedian $105 · 10th to 90th $62 to $170
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 $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None (both parts) Typical Low $79.43 Median $95.50 Typical High $120.23 | Professional | None (both parts) | $79.43 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $44.67 Median $52.48 Typical High $60.26 | Professional | 26 · Professional part | $44.67 | $52.48 | $60.26 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $34.67 Median $43.65 Typical High $61.66 | Professional | TC · Technical part | $34.67 | $43.65 | $61.66 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $134.90 Median $134.90 Typical High $151.36 | Professional | None (both parts) | $134.90 | $134.90 | $151.36 |
BCBS South Carolina Setting Facility Modifier None Typical Low $389.05 Median $870.96 Typical High $1,230.27 | Facility | None | $389.05 | $870.96 | $1,230.27 |
BCBS South Carolina Setting Facility Modifier TC · Technical part Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | TC · Technical part | $524.81 | $524.81 | $524.81 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $97.72 Median $100.00 Typical High $154.88 | Professional | None (both parts) | $97.72 | $100.00 | $154.88 |
BCBS South Carolina Setting Professional Modifier 26 · Professional part Typical Low $46.77 Median $52.48 Typical High $85.11 | Professional | 26 · Professional part | $46.77 | $52.48 | $85.11 |
BCBS South Carolina Setting Professional Modifier TC · Technical part Typical Low $50.12 Median $50.12 Typical High $61.66 | Professional | TC · Technical part | $50.12 | $50.12 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $134.90 Typical High $707.95 | Facility | None | $61.66 | $134.90 | $707.95 |
Cigna Setting Professional Modifier None (both parts) Typical Low $102.33 Median $112.20 Typical High $181.97 | Professional | None (both parts) | $102.33 | $112.20 | $181.97 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $52.48 Median $58.88 Typical High $100.00 | Professional | 26 · Professional part | $52.48 | $58.88 | $100.00 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $45.71 Median $60.26 Typical High $85.11 | Professional | TC · Technical part | $45.71 | $60.26 | $85.11 |
Medcost Setting Facility Modifier None Typical Low $46.77 Median $72.44 Typical High $107.15 | Facility | None | $46.77 | $72.44 | $107.15 |
Medcost Setting Professional Modifier None (both parts) Typical Low $77.62 Median $117.49 Typical High $134.90 | Professional | None (both parts) | $77.62 | $117.49 | $134.90 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $54.95 Median $58.88 Typical High $79.43 | Professional | 26 · Professional part | $54.95 | $58.88 | $79.43 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $56.23 Median $64.57 Typical High $69.18 | Professional | TC · Technical part | $56.23 | $64.57 | $69.18 |
Molina Setting Professional Modifier None (both parts) Typical Low $52.48 Median $102.33 Typical High $173.78 | Professional | None (both parts) | $52.48 | $102.33 | $173.78 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None (both parts) Typical Low $75.86 Median $104.71 Typical High $186.21 | Professional | None (both parts) | $75.86 | $104.71 | $186.21 |
United Setting Professional Modifier 26 · Professional part Typical Low $41.69 Median $53.70 Typical High $100.00 | Professional | 26 · Professional part | $41.69 | $53.70 | $100.00 |
United Setting Professional Modifier TC · Technical part Typical Low $31.62 Median $50.12 Typical High $83.18 | Professional | TC · Technical part | $31.62 | $50.12 | $83.18 |
9 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 $39.81 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $39.81 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $15.85 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $11.75 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.94 | $9.55 | $9.55 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $50.12 Median $58.88 Typical High $72.44 | Professional | 51 · Multiple procedures | $50.12 | $58.88 | $72.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $21.88 Median $23.99 Typical High $28.84 | Professional | 80 · Assistant surgeon | $21.88 | $23.99 | $28.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.14 Median $16.60 Typical High $20.42 | Professional | 81 · Minimal assistant surgeon | $15.14 | $16.60 | $20.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.14 Median $16.60 Typical High $20.42 | Professional | 82 · Assistant surgeon, no resident | $15.14 | $16.60 | $20.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.14 Median $16.60 Typical High $20.42 | Professional | AS · PA/NP assist | $15.14 | $16.60 | $20.42 |
Where South Carolina sits
The same service costs 5.9 times more in Alaska than in Alabama. 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· 31st of 51
$112
AK $331AL $56.23
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.