How much rates vary
Facilitymedian $158 · 10th to 90th $43 to $302Professionalmedian $38 · 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 $35.48 Typical High $91.20 | Facility | None | $28.18 | $35.48 | $91.20 |
Aetna Setting Professional Modifier None (both parts) Typical Low $28.18 Median $29.51 Typical High $50.12 | Professional | None (both parts) | $28.18 | $29.51 | $50.12 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $6.76 Median $7.24 Typical High $12.59 | Professional | 26 · Professional part | $6.76 | $7.24 | $12.59 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $20.89 Median $22.39 Typical High $37.15 | Professional | TC · Technical part | $20.89 | $22.39 | $37.15 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $25.70 Median $34.67 Typical High $57.54 | Professional | None (both parts) | $25.70 | $34.67 | $57.54 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $6.31 Median $8.51 Typical High $14.45 | Professional | 26 · Professional part | $6.31 | $8.51 | $14.45 |
Ambetter Setting Professional Modifier TC · Technical part Typical Low $23.99 Median $28.84 Typical High $37.15 | Professional | TC · Technical part | $23.99 | $28.84 | $37.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $89.13 Median $165.96 Typical High $295.12 | Facility | None | $89.13 | $165.96 | $295.12 |
BCBS South Carolina Setting Facility Modifier TC · Technical part Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | TC · Technical part | $61.66 | $61.66 | $61.66 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $31.62 Median $37.15 Typical High $56.23 | Professional | None (both parts) | $31.62 | $37.15 | $56.23 |
BCBS South Carolina Setting Professional Modifier 26 · Professional part Typical Low $7.76 Median $19.05 Typical High $25.70 | Professional | 26 · Professional part | $7.76 | $19.05 | $25.70 |
BCBS South Carolina Setting Professional Modifier TC · Technical part Typical Low $15.14 Median $23.99 Typical High $33.88 | Professional | TC · Technical part | $15.14 | $23.99 | $33.88 |
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 $27.54 Median $32.36 Typical High $60.26 | Professional | None (both parts) | $27.54 | $32.36 | $60.26 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $7.94 Median $9.55 Typical High $16.60 | Professional | 26 · Professional part | $7.94 | $9.55 | $16.60 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $19.95 Median $22.91 Typical High $44.67 | Professional | TC · Technical part | $19.95 | $22.91 | $44.67 |
Medcost Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Medcost Setting Facility Modifier None Typical Low $26.92 Median $38.02 Typical High $162.18 | Facility | None | $26.92 | $38.02 | $162.18 |
Medcost Setting Professional Modifier None (both parts) Typical Low $38.90 Median $45.71 Typical High $67.61 | Professional | None (both parts) | $38.90 | $45.71 | $67.61 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $12.02 Median $15.14 Typical High $24.55 | Professional | 26 · Professional part | $12.02 | $15.14 | $24.55 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $28.84 Median $31.62 Typical High $44.67 | Professional | TC · Technical part | $28.84 | $31.62 | $44.67 |
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 $36.31 Typical High $64.57 | Professional | None (both parts) | $26.30 | $36.31 | $64.57 |
United Setting Professional Modifier 26 · Professional part Typical Low $7.59 Median $9.77 Typical High $17.38 | Professional | 26 · Professional part | $7.59 | $9.77 | $17.38 |
United Setting Professional Modifier TC · Technical part Typical Low $18.62 Median $25.70 Typical High $47.86 | Professional | TC · Technical part | $18.62 | $25.70 | $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 $14.13 Median $14.13 Typical High $15.14 | Professional | 52 · Reduced service | $14.13 | $14.13 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $6.03 | Professional | 53 · Discontinued | $5.62 | $5.62 | $6.03 |
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 $38.02 Median $52.48 Typical High $87.10 | Professional | 50 · Both sides | $38.02 | $52.48 | $87.10 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $61.66 Median $72.44 Typical High $100.00 | Professional | 50 · Both sides | $61.66 | $72.44 | $100.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $20.42 Median $23.99 Typical High $33.88 | Professional | 51 · Multiple procedures | $20.42 | $23.99 | $33.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.13 Median $9.55 Typical High $13.49 | Professional | 80 · Assistant surgeon | $8.13 | $9.55 | $13.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.75 Median $6.76 Typical High $9.33 | Professional | 81 · Minimal assistant surgeon | $5.75 | $6.76 | $9.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.75 Median $6.76 Typical High $9.33 | Professional | 82 · Assistant surgeon, no resident | $5.75 | $6.76 | $9.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.75 Median $6.76 Typical High $9.33 | Professional | AS · PA/NP assist | $5.75 | $6.76 | $9.33 |
Where South Carolina sits
The same service costs 15.1 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· 23rd of 51
$39.81
VT $407FL $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.