How much rates vary
Facilitymedian $741 · 10th to 90th $85 to $2,291Professionalmedian $36 · 10th to 90th $22 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 $34.67 Median $34.67 Typical High $64.57 | Facility | None | $34.67 | $34.67 | $64.57 |
Aetna Setting Professional Modifier None (both parts) Typical Low $20.42 Median $34.67 Typical High $44.67 | Professional | None (both parts) | $20.42 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $8.13 Median $12.88 Typical High $15.49 | Professional | 26 · Professional part | $8.13 | $12.88 | $15.49 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $12.59 Median $21.88 Typical High $26.92 | Professional | TC · Technical part | $12.59 | $21.88 | $26.92 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $14.45 Median $15.85 Typical High $26.30 | Professional | 26 · Professional part | $14.45 | $15.85 | $26.30 |
BCBS South Carolina Setting Facility Modifier None Typical Low $169.82 Median $741.31 Typical High $2,290.87 | Facility | None | $169.82 | $741.31 | $2,290.87 |
BCBS South Carolina Setting Facility Modifier TC · Technical part Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | TC · Technical part | $316.23 | $316.23 | $316.23 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $32.36 Typical High $46.77 | Professional | None (both parts) | $30.20 | $32.36 | $46.77 |
BCBS South Carolina Setting Professional Modifier 26 · Professional part Typical Low $8.91 Median $14.45 Typical High $18.20 | Professional | 26 · Professional part | $8.91 | $14.45 | $18.20 |
BCBS South Carolina Setting Professional Modifier TC · Technical part Typical Low $14.13 Median $20.89 Typical High $27.54 | Professional | TC · Technical part | $14.13 | $20.89 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $1,445.44 Typical High $2,884.03 | Facility | None | $169.82 | $1,445.44 | $2,884.03 |
Cigna Setting Professional Modifier None (both parts) Typical Low $19.05 Median $23.44 Typical High $70.79 | Professional | None (both parts) | $19.05 | $23.44 | $70.79 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $7.24 Median $9.55 Typical High $26.30 | Professional | 26 · Professional part | $7.24 | $9.55 | $26.30 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $10.72 Median $14.45 Typical High $45.71 | Professional | TC · Technical part | $10.72 | $14.45 | $45.71 |
Medcost Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Medcost Setting Facility Modifier None Typical Low $20.89 Median $46.77 Typical High $776.25 | Facility | None | $20.89 | $46.77 | $776.25 |
Medcost Setting Professional Modifier None (both parts) Typical Low $26.30 Median $38.02 Typical High $58.88 | Professional | None (both parts) | $26.30 | $38.02 | $58.88 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $11.75 Median $14.13 Typical High $27.54 | Professional | 26 · Professional part | $11.75 | $14.13 | $27.54 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $13.80 Median $22.39 Typical High $46.77 | Professional | TC · Technical part | $13.80 | $22.39 | $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 $2,290.87 Median $2,754.23 Typical High $3,630.78 | Facility | None | $2,290.87 | $2,754.23 | $3,630.78 |
United Setting Professional Modifier None (both parts) Typical Low $17.38 Median $38.90 Typical High $77.62 | Professional | None (both parts) | $17.38 | $38.90 | $77.62 |
United Setting Professional Modifier 26 · Professional part Typical Low $7.59 Median $15.14 Typical High $27.54 | Professional | 26 · Professional part | $7.59 | $15.14 | $27.54 |
United Setting Professional Modifier TC · Technical part Typical Low $9.55 Median $23.99 Typical High $50.12 | Professional | TC · Technical part | $9.55 | $23.99 | $50.12 |
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 $17.38 Median $17.38 Typical High $17.78 | Professional | 52 · Reduced service | $17.38 | $17.38 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $7.24 | Professional | 53 · Discontinued | $6.92 | $6.92 | $7.24 |
Aetna Setting Professional Modifier FX · Film X-ray Typical Low $27.54 Median $27.54 Typical High $28.18 | Professional | FX · Film X-ray | $27.54 | $27.54 | $28.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $13.18 Median $19.05 Typical High $37.15 | Professional | 51 · Multiple procedures | $13.18 | $19.05 | $37.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.25 Median $7.59 Typical High $14.79 | Professional | 80 · Assistant surgeon | $5.25 | $7.59 | $14.79 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.63 Median $5.37 Typical High $10.23 | Professional | 81 · Minimal assistant surgeon | $3.63 | $5.37 | $10.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.63 Median $5.37 Typical High $10.23 | Professional | 82 · Assistant surgeon, no resident | $3.63 | $5.37 | $10.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.63 Median $5.37 Typical High $10.23 | Professional | AS · PA/NP assist | $3.63 | $5.37 | $10.23 |
Where South Carolina sits
The same service costs 9.3 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· 32nd of 51
$38.90
AK $123NY $13.18
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.