How much rates vary
Facilitymedian $155 · 10th to 90th $49 to $295Professionalmedian $37 · 10th to 90th $26 to $60
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 $26.30 Median $33.11 Typical High $50.12 | Facility | None | $26.30 | $33.11 | $50.12 |
Aetna Setting Professional Modifier None (both parts) Typical Low $26.30 Median $26.30 Typical High $47.86 | Professional | None (both parts) | $26.30 | $26.30 | $47.86 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $6.76 Median $7.08 Typical High $12.59 | Professional | 26 · Professional part | $6.76 | $7.08 | $12.59 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $19.50 Median $19.50 Typical High $36.31 | Professional | TC · Technical part | $19.50 | $19.50 | $36.31 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $34.67 Median $48.98 Typical High $57.54 | Professional | None (both parts) | $34.67 | $48.98 | $57.54 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $6.17 Median $8.51 Typical High $14.45 | Professional | 26 · Professional part | $6.17 | $8.51 | $14.45 |
Ambetter Setting Professional Modifier TC · Technical part Typical Low $25.70 Median $33.88 Typical High $35.48 | Professional | TC · Technical part | $25.70 | $33.88 | $35.48 |
BCBS South Carolina Setting Facility Modifier None Typical Low $79.43 Median $162.18 Typical High $295.12 | Facility | None | $79.43 | $162.18 | $295.12 |
BCBS South Carolina Setting Facility Modifier TC · Technical part Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | TC · Technical part | $60.26 | $60.26 | $60.26 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $30.90 Median $36.31 Typical High $51.29 | Professional | None (both parts) | $30.90 | $36.31 | $51.29 |
BCBS South Carolina Setting Professional Modifier 26 · Professional part Typical Low $7.76 Median $18.20 Typical High $23.99 | Professional | 26 · Professional part | $7.76 | $18.20 | $23.99 |
BCBS South Carolina Setting Professional Modifier TC · Technical part Typical Low $15.14 Median $23.44 Typical High $30.90 | Professional | TC · Technical part | $15.14 | $23.44 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $234.42 Typical High $467.74 | Facility | None | $151.36 | $234.42 | $467.74 |
Cigna Setting Professional Modifier None (both parts) Typical Low $25.12 Median $30.90 Typical High $56.23 | Professional | None (both parts) | $25.12 | $30.90 | $56.23 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $7.24 Median $9.33 Typical High $16.22 | Professional | 26 · Professional part | $7.24 | $9.33 | $16.22 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $17.78 Median $20.89 Typical High $40.74 | Professional | TC · Technical part | $17.78 | $20.89 | $40.74 |
Medcost Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Medcost Setting Facility Modifier None Typical Low $25.70 Median $35.48 Typical High $162.18 | Facility | None | $25.70 | $35.48 | $162.18 |
Medcost Setting Professional Modifier None (both parts) Typical Low $36.31 Median $43.65 Typical High $52.48 | Professional | None (both parts) | $36.31 | $43.65 | $52.48 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $11.75 Median $14.13 Typical High $19.95 | Professional | 26 · Professional part | $11.75 | $14.13 | $19.95 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $25.12 Median $30.20 Typical High $51.29 | Professional | TC · Technical part | $25.12 | $30.20 | $51.29 |
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 $24.55 Median $33.11 Typical High $60.26 | Professional | None (both parts) | $24.55 | $33.11 | $60.26 |
United Setting Professional Modifier 26 · Professional part Typical Low $7.59 Median $9.33 Typical High $16.98 | Professional | 26 · Professional part | $7.59 | $9.33 | $16.98 |
United Setting Professional Modifier TC · Technical part Typical Low $16.98 Median $23.44 Typical High $44.67 | Professional | TC · Technical part | $16.98 | $23.44 | $44.67 |
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 $13.18 Median $13.18 Typical High $14.13 | Professional | 52 · Reduced service | $13.18 | $13.18 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $5.62 | Professional | 53 · Discontinued | $5.25 | $5.25 | $5.62 |
Aetna Setting Professional Modifier FX · Film X-ray Typical Low $20.89 Median $20.89 Typical High $22.39 | Professional | FX · Film X-ray | $20.89 | $20.89 | $22.39 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $56.23 Median $66.07 Typical High $93.33 | Professional | 50 · Both sides | $56.23 | $66.07 | $93.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $18.62 Median $21.88 Typical High $30.90 | Professional | 51 · Multiple procedures | $18.62 | $21.88 | $30.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.41 Median $8.71 Typical High $12.30 | Professional | 80 · Assistant surgeon | $7.41 | $8.71 | $12.30 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.25 Median $6.17 Typical High $8.71 | Professional | 81 · Minimal assistant surgeon | $5.25 | $6.17 | $8.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.25 Median $6.17 Typical High $8.71 | Professional | 82 · Assistant surgeon, no resident | $5.25 | $6.17 | $8.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.25 Median $6.17 Typical High $8.71 | Professional | AS · PA/NP assist | $5.25 | $6.17 | $8.71 |
Where South Carolina sits
The same service costs 6.0 times more in Vermont than in Florida. 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
$38.90
VT $155FL $25.70
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.