How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $107.15 | Professional | None | $91.20 | $91.20 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
BCBS South Carolina Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $181.97 | Professional | None | $104.71 | $104.71 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $218.78 | Professional | None | $102.33 | $144.54 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $104.71 Typical High $295.12 | Facility | None | $91.20 | $104.71 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $251.19 | Professional | None | $144.54 | $181.97 | $251.19 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $194.98 | Professional | None | $104.71 | $158.49 | $194.98 |
United Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $208.93 | Professional | None | $97.72 | $128.82 | $208.93 |
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 $45.71 Median $45.71 Typical High $52.48 | Professional | 52 · Reduced service | $45.71 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | 53 · Discontinued | $18.20 | $18.20 | $21.38 |
Aetna Setting Professional Modifier FX · Film X-ray Typical Low $72.44 Median $72.44 Typical High $85.11 | Professional | FX · Film X-ray | $72.44 | $72.44 | $85.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $89.13 Typical High $125.89 | Professional | 51 · Multiple procedures | $75.86 | $89.13 | $125.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.90 Median $36.31 Typical High $50.12 | Professional | 80 · Assistant surgeon | $30.90 | $36.31 | $50.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.38 Median $25.12 Typical High $35.48 | Professional | 81 · Minimal assistant surgeon | $21.38 | $25.12 | $35.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.38 Median $25.12 Typical High $35.48 | Professional | 82 · Assistant surgeon, no resident | $21.38 | $25.12 | $35.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $21.38 Median $25.12 Typical High $35.48 | Professional | AS · PA/NP assist | $21.38 | $25.12 | $35.48 |
Where South Carolina sits
The same service costs 4.2 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· 38th of 51
$126
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.