How much rates vary
Facilitymedian $269 · 10th to 90th $117 to $427Professionalmedian $105 · 10th to 90th $66 to $170
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 $91.20 Median $91.20 Typical High $138.04 | Facility | None | $91.20 | $91.20 | $138.04 |
Aetna Setting Professional Modifier None (both parts) Typical Low $91.20 Median $91.20 Typical High $154.88 | Professional | None (both parts) | $91.20 | $91.20 | $154.88 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $34.67 Median $34.67 Typical High $58.88 | Professional | 26 · Professional part | $34.67 | $34.67 | $58.88 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $56.23 Median $56.23 Typical High $100.00 | Professional | TC · Technical part | $56.23 | $56.23 | $100.00 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $104.71 Median $117.49 Typical High $177.83 | Professional | None (both parts) | $104.71 | $117.49 | $177.83 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $31.62 Median $39.81 Typical High $72.44 | Professional | 26 · Professional part | $31.62 | $39.81 | $72.44 |
Ambetter Setting Professional Modifier TC · Technical part Typical Low $52.48 Median $61.66 Typical High $61.66 | Professional | TC · Technical part | $52.48 | $61.66 | $61.66 |
BCBS South Carolina Setting Facility Modifier None Typical Low $134.90 Median $251.19 Typical High $407.38 | Facility | None | $134.90 | $251.19 | $407.38 |
BCBS South Carolina Setting Facility Modifier TC · Technical part Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | TC · Technical part | $128.82 | $128.82 | $128.82 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $87.10 Median $104.71 Typical High $144.54 | Professional | None (both parts) | $87.10 | $104.71 | $144.54 |
BCBS South Carolina Setting Professional Modifier 26 · Professional part Typical Low $39.81 Median $47.86 Typical High $75.86 | Professional | 26 · Professional part | $39.81 | $47.86 | $75.86 |
BCBS South Carolina Setting Professional Modifier TC · Technical part Typical Low $39.81 Median $42.66 Typical High $67.61 | Professional | TC · Technical part | $39.81 | $42.66 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $331.13 Typical High $562.34 | Facility | None | $281.84 | $331.13 | $562.34 |
Cigna Setting Professional Modifier None (both parts) Typical Low $95.50 Median $109.65 Typical High $204.17 | Professional | None (both parts) | $95.50 | $109.65 | $204.17 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $38.90 Median $44.67 Typical High $74.13 | Professional | 26 · Professional part | $38.90 | $44.67 | $74.13 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $51.29 Median $63.10 Typical High $128.82 | Professional | TC · Technical part | $51.29 | $63.10 | $128.82 |
Medcost Setting Facility Modifier None Typical Low $81.28 Median $123.03 Typical High $309.03 | Facility | None | $81.28 | $123.03 | $309.03 |
Medcost Setting Professional Modifier None (both parts) Typical Low $120.23 Median $138.04 Typical High $245.47 | Professional | None (both parts) | $120.23 | $138.04 | $245.47 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $60.26 Median $69.18 Typical High $81.28 | Professional | 26 · Professional part | $60.26 | $69.18 | $81.28 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $79.43 Median $85.11 Typical High $120.23 | Professional | TC · Technical part | $79.43 | $85.11 | $120.23 |
Molina Setting Professional Modifier None (both parts) Typical Low $50.12 Median $100.00 Typical High $165.96 | Professional | None (both parts) | $50.12 | $100.00 | $165.96 |
United Setting Facility Modifier None Typical Low $436.52 Median $537.03 Typical High $691.83 | Facility | None | $436.52 | $537.03 | $691.83 |
United Setting Professional Modifier None (both parts) Typical Low $91.20 Median $112.20 Typical High $194.98 | Professional | None (both parts) | $91.20 | $112.20 | $194.98 |
United Setting Professional Modifier 26 · Professional part Typical Low $35.48 Median $43.65 Typical High $77.62 | Professional | 26 · Professional part | $35.48 | $43.65 | $77.62 |
United Setting Professional Modifier TC · Technical part Typical Low $53.70 Median $66.07 Typical High $123.03 | Professional | TC · Technical part | $53.70 | $66.07 | $123.03 |
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 $44.67 Median $44.67 Typical High $48.98 | Professional | 52 · Reduced service | $44.67 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $19.50 | Professional | 53 · Discontinued | $18.20 | $18.20 | $19.50 |
Aetna Setting Professional Modifier FX · Film X-ray Typical Low $72.44 Median $72.44 Typical High $77.62 | Professional | FX · Film X-ray | $72.44 | $72.44 | $77.62 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $158.49 Median $194.98 Typical High $194.98 | Professional | 59 · Distinct service | $158.49 | $194.98 | $194.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $60.26 Median $72.44 Typical High $123.03 | Professional | 51 · Multiple procedures | $60.26 | $72.44 | $123.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $23.99 Median $28.84 Typical High $48.98 | Professional | 80 · Assistant surgeon | $23.99 | $28.84 | $48.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.98 Median $19.95 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $16.98 | $19.95 | $33.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.98 Median $19.95 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $16.98 | $19.95 | $33.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.98 Median $19.95 Typical High $33.88 | Professional | AS · PA/NP assist | $16.98 | $19.95 | $33.88 |
Where South Carolina sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 42nd of 51
$107
AK $331UT $72.44
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.