How much rates vary
Facilitymedian $162 · 10th to 90th $48 to $302Professionalmedian $39 · 10th to 90th $30 to $63
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 $30.20 Median $38.90 Typical High $100.00 | Facility | None | $30.20 | $38.90 | $100.00 |
Aetna Setting Professional Modifier None (both parts) Typical Low $30.20 Median $30.20 Typical High $53.70 | Professional | None (both parts) | $30.20 | $30.20 | $53.70 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $7.08 Median $7.59 Typical High $13.18 | Professional | 26 · Professional part | $7.08 | $7.59 | $13.18 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $22.91 Median $22.91 Typical High $40.74 | Professional | TC · Technical part | $22.91 | $22.91 | $40.74 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $30.20 Median $51.29 Typical High $64.57 | Professional | None (both parts) | $30.20 | $51.29 | $64.57 |
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 $26.92 Median $38.02 Typical High $50.12 | Professional | TC · Technical part | $26.92 | $38.02 | $50.12 |
BCBS South Carolina Setting Facility Modifier None Typical Low $89.13 Median $169.82 Typical High $295.12 | Facility | None | $89.13 | $169.82 | $295.12 |
BCBS South Carolina Setting Facility Modifier TC · Technical part Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | TC · Technical part | $63.10 | $63.10 | $63.10 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $34.67 Median $38.90 Typical High $57.54 | Professional | None (both parts) | $34.67 | $38.90 | $57.54 |
BCBS South Carolina Setting Professional Modifier 26 · Professional part Typical Low $8.51 Median $19.05 Typical High $25.12 | Professional | 26 · Professional part | $8.51 | $19.05 | $25.12 |
BCBS South Carolina Setting Professional Modifier TC · Technical part Typical Low $15.49 Median $26.92 Typical High $34.67 | Professional | TC · Technical part | $15.49 | $26.92 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $234.42 Typical High $467.74 | Facility | None | $177.83 | $234.42 | $467.74 |
Cigna Setting Professional Modifier None (both parts) Typical Low $27.54 Median $33.88 Typical High $63.10 | Professional | None (both parts) | $27.54 | $33.88 | $63.10 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $7.94 Median $10.00 Typical High $16.98 | Professional | 26 · Professional part | $7.94 | $10.00 | $16.98 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $19.95 Median $23.99 Typical High $47.86 | Professional | TC · Technical part | $19.95 | $23.99 | $47.86 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Medcost Setting Facility Modifier None Typical Low $26.92 Median $40.74 Typical High $162.18 | Facility | None | $26.92 | $40.74 | $162.18 |
Medcost Setting Professional Modifier None (both parts) Typical Low $41.69 Median $45.71 Typical High $60.26 | Professional | None (both parts) | $41.69 | $45.71 | $60.26 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $12.02 Median $15.14 Typical High $20.89 | Professional | 26 · Professional part | $12.02 | $15.14 | $20.89 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $29.51 Median $31.62 Typical High $48.98 | Professional | TC · Technical part | $29.51 | $31.62 | $48.98 |
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 $26.30 Median $37.15 Typical High $69.18 | Professional | None (both parts) | $26.30 | $37.15 | $69.18 |
United Setting Professional Modifier 26 · Professional part Typical Low $7.94 Median $9.77 Typical High $17.78 | Professional | 26 · Professional part | $7.94 | $9.77 | $17.78 |
United Setting Professional Modifier TC · Technical part Typical Low $19.05 Median $26.92 Typical High $52.48 | Professional | TC · Technical part | $19.05 | $26.92 | $52.48 |
10 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 $15.14 Median $15.14 Typical High $15.85 | Professional | 52 · Reduced service | $15.14 | $15.14 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $6.31 | Professional | 53 · Discontinued | $6.03 | $6.03 | $6.31 |
Aetna Setting Professional Modifier FX · Film X-ray Typical Low $23.99 Median $23.99 Typical High $25.70 | Professional | FX · Film X-ray | $23.99 | $23.99 | $25.70 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $58.88 Median $81.28 Typical High $97.72 | Professional | 50 · Both sides | $58.88 | $81.28 | $97.72 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $61.66 Median $74.13 Typical High $107.15 | Professional | 50 · Both sides | $61.66 | $74.13 | $107.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $20.89 Median $24.55 Typical High $35.48 | Professional | 51 · Multiple procedures | $20.89 | $24.55 | $35.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.32 Median $9.77 Typical High $14.13 | Professional | 80 · Assistant surgeon | $8.32 | $9.77 | $14.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.75 Median $6.92 Typical High $10.00 | Professional | 81 · Minimal assistant surgeon | $5.75 | $6.92 | $10.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.75 Median $6.92 Typical High $10.00 | Professional | 82 · Assistant surgeon, no resident | $5.75 | $6.92 | $10.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.75 Median $6.92 Typical High $10.00 | Professional | AS · PA/NP assist | $5.75 | $6.92 | $10.00 |
Where South Carolina sits
The same service costs 13.5 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
$41.69
VT $389FL $28.84
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.