How much rates vary
Facilitymedian $158 · 10th to 90th $39 to $295Professionalmedian $39 · 10th to 90th $28 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 $28.18 Median $34.67 Typical High $51.29 | Facility | None | $28.18 | $34.67 | $51.29 |
Aetna Setting Professional Modifier None (both parts) Typical Low $28.18 Median $29.51 Typical High $51.29 | Professional | None (both parts) | $28.18 | $29.51 | $51.29 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $6.76 Median $7.24 Typical High $12.88 | Professional | 26 · Professional part | $6.76 | $7.24 | $12.88 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $20.89 Median $21.38 Typical High $37.15 | Professional | TC · Technical part | $20.89 | $21.38 | $37.15 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $27.54 Median $44.67 Typical High $57.54 | Professional | None (both parts) | $27.54 | $44.67 | $57.54 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $6.17 Median $7.76 Typical High $14.45 | Professional | 26 · Professional part | $6.17 | $7.76 | $14.45 |
Ambetter Setting Professional Modifier TC · Technical part Typical Low $24.55 Median $33.88 Typical High $43.65 | Professional | TC · Technical part | $24.55 | $33.88 | $43.65 |
BCBS South Carolina Setting Facility Modifier None Typical Low $70.79 Median $158.49 Typical High $295.12 | Facility | None | $70.79 | $158.49 | $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 $32.36 Median $38.02 Typical High $57.54 | Professional | None (both parts) | $32.36 | $38.02 | $57.54 |
BCBS South Carolina Setting Professional Modifier 26 · Professional part Typical Low $7.76 Median $18.62 Typical High $24.55 | Professional | 26 · Professional part | $7.76 | $18.62 | $24.55 |
BCBS South Carolina Setting Professional Modifier TC · Technical part Typical Low $16.60 Median $24.55 Typical High $30.20 | Professional | TC · Technical part | $16.60 | $24.55 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $234.42 Typical High $467.74 | Facility | None | $158.49 | $234.42 | $467.74 |
Cigna Setting Professional Modifier None (both parts) Typical Low $26.30 Median $31.62 Typical High $60.26 | Professional | None (both parts) | $26.30 | $31.62 | $60.26 |
Cigna 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 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $18.20 Median $22.91 Typical High $43.65 | Professional | TC · Technical part | $18.20 | $22.91 | $43.65 |
Medcost 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 $26.30 Median $38.02 Typical High $162.18 | Facility | None | $26.30 | $38.02 | $162.18 |
Medcost Setting Professional Modifier None (both parts) Typical Low $38.02 Median $44.67 Typical High $54.95 | Professional | None (both parts) | $38.02 | $44.67 | $54.95 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $12.30 Median $15.14 Typical High $19.95 | Professional | 26 · Professional part | $12.30 | $15.14 | $19.95 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $25.70 Median $30.20 Typical High $46.77 | Professional | TC · Technical part | $25.70 | $30.20 | $46.77 |
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 $25.70 Median $34.67 Typical High $64.57 | Professional | None (both parts) | $25.70 | $34.67 | $64.57 |
United 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 |
United Setting Professional Modifier TC · Technical part Typical Low $17.38 Median $25.12 Typical High $47.86 | Professional | TC · Technical part | $17.38 | $25.12 | $47.86 |
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 $13.80 Median $13.80 Typical High $14.79 | Professional | 52 · Reduced service | $13.80 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $5.89 | Professional | 53 · Discontinued | $5.62 | $5.62 | $5.89 |
Aetna Setting Professional Modifier FX · Film X-ray Typical Low $22.39 Median $22.39 Typical High $23.99 | Professional | FX · Film X-ray | $22.39 | $22.39 | $23.99 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $38.90 Median $47.86 Typical High $89.13 | Professional | 50 · Both sides | $38.90 | $47.86 | $89.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $57.54 Median $69.18 Typical High $93.33 | Professional | 50 · Both sides | $57.54 | $69.18 | $93.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.05 Median $22.91 Typical High $31.62 | Professional | 51 · Multiple procedures | $19.05 | $22.91 | $31.62 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.59 Median $9.12 Typical High $12.59 | Professional | 80 · Assistant surgeon | $7.59 | $9.12 | $12.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.37 Median $6.46 Typical High $8.71 | Professional | 81 · Minimal assistant surgeon | $5.37 | $6.46 | $8.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.37 Median $6.46 Typical High $8.71 | Professional | 82 · Assistant surgeon, no resident | $5.37 | $6.46 | $8.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.37 Median $6.46 Typical High $8.71 | Professional | AS · PA/NP assist | $5.37 | $6.46 | $8.71 |
Where South Carolina sits
The same service costs 12.9 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
$40.74
VT $347FL $26.92
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.