How much rates vary
Facilitymedian $151 · 10th to 90th $46 to $295Professionalmedian $36 · 10th to 90th $26 to $59
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 $25.70 Median $32.36 Typical High $46.77 | Facility | None | $25.70 | $32.36 | $46.77 |
Aetna Setting Professional Modifier None (both parts) Typical Low $25.70 Median $25.70 Typical High $43.65 | Professional | None (both parts) | $25.70 | $25.70 | $43.65 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $7.41 Median $7.41 Typical High $11.75 | Professional | 26 · Professional part | $7.41 | $7.41 | $11.75 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $18.62 Median $18.62 Typical High $29.51 | Professional | TC · Technical part | $18.62 | $18.62 | $29.51 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $23.44 Median $23.44 Typical High $28.84 | Professional | None (both parts) | $23.44 | $23.44 | $28.84 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $6.76 Median $9.33 Typical High $15.49 | Professional | 26 · Professional part | $6.76 | $9.33 | $15.49 |
Ambetter Setting Professional Modifier TC · Technical part Typical Low $24.55 Median $24.55 Typical High $28.84 | Professional | TC · Technical part | $24.55 | $24.55 | $28.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $83.18 Median $162.18 Typical High $295.12 | Facility | None | $83.18 | $162.18 | $295.12 |
BCBS South Carolina Setting Facility Modifier TC · Technical part Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | TC · Technical part | $57.54 | $57.54 | $57.54 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $28.84 Median $33.11 Typical High $47.86 | Professional | None (both parts) | $28.84 | $33.11 | $47.86 |
BCBS South Carolina Setting Professional Modifier 26 · Professional part Typical Low $8.51 Median $16.98 Typical High $21.88 | Professional | 26 · Professional part | $8.51 | $16.98 | $21.88 |
BCBS South Carolina Setting Professional Modifier TC · Technical part Typical Low $14.13 Median $20.42 Typical High $25.70 | Professional | TC · Technical part | $14.13 | $20.42 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $234.42 Typical High $467.74 | Facility | None | $138.04 | $234.42 | $467.74 |
Cigna Setting Professional Modifier None (both parts) Typical Low $23.99 Median $30.20 Typical High $53.70 | Professional | None (both parts) | $23.99 | $30.20 | $53.70 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $7.94 Median $9.77 Typical High $16.60 | Professional | 26 · Professional part | $7.94 | $9.77 | $16.60 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $16.22 Median $20.89 Typical High $37.15 | Professional | TC · Technical part | $16.22 | $20.89 | $37.15 |
Medcost Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Medcost Setting Facility Modifier None Typical Low $22.39 Median $34.67 Typical High $162.18 | Facility | None | $22.39 | $34.67 | $162.18 |
Medcost Setting Professional Modifier None (both parts) Typical Low $35.48 Median $38.90 Typical High $56.23 | Professional | None (both parts) | $35.48 | $38.90 | $56.23 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $12.02 Median $15.14 Typical High $19.50 | Professional | 26 · Professional part | $12.02 | $15.14 | $19.50 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $23.99 Median $25.70 Typical High $41.69 | Professional | TC · Technical part | $23.99 | $25.70 | $41.69 |
Molina Setting Professional Modifier None (both parts) Typical Low $32.36 Median $43.65 Typical High $61.66 | Professional | None (both parts) | $32.36 | $43.65 | $61.66 |
United Setting Facility Modifier None Typical Low $363.08 Median $446.68 Typical High $575.44 | Facility | None | $363.08 | $446.68 | $575.44 |
United Setting Professional Modifier None (both parts) Typical Low $23.44 Median $32.36 Typical High $58.88 | Professional | None (both parts) | $23.44 | $32.36 | $58.88 |
United Setting Professional Modifier 26 · Professional part Typical Low $7.94 Median $10.00 Typical High $17.78 | Professional | 26 · Professional part | $7.94 | $10.00 | $17.78 |
United Setting Professional Modifier TC · Technical part Typical Low $15.49 Median $21.88 Typical High $41.69 | Professional | TC · Technical part | $15.49 | $21.88 | $41.69 |
8 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 $12.88 Median $12.88 Typical High $13.80 | Professional | 52 · Reduced service | $12.88 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.50 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.50 |
Aetna Setting Professional Modifier FX · Film X-ray Typical Low $20.89 Median $20.89 Typical High $21.88 | Professional | FX · Film X-ray | $20.89 | $20.89 | $21.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $17.78 Median $19.50 Typical High $30.90 | Professional | 51 · Multiple procedures | $17.78 | $19.50 | $30.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.24 Median $7.76 Typical High $12.30 | Professional | 80 · Assistant surgeon | $7.24 | $7.76 | $12.30 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.01 Median $5.50 Typical High $8.71 | Professional | 81 · Minimal assistant surgeon | $5.01 | $5.50 | $8.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.01 Median $5.50 Typical High $8.71 | Professional | 82 · Assistant surgeon, no resident | $5.01 | $5.50 | $8.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.01 Median $5.50 Typical High $8.71 | Professional | AS · PA/NP assist | $5.01 | $5.50 | $8.71 |
Where South Carolina sits
The same service costs 4.3 times more in Alaska than in New York. 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· 24th of 51
$38.02
AK $93.33NY $21.88
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.