How much rates vary
Facilitymedian $537 · 10th to 90th $224 to $794Professionalmedian $158 · 10th to 90th $120 to $240
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 $109.65 Median $109.65 Typical High $380.19 | Facility | None | $109.65 | $109.65 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $186.21 | Professional | None | $109.65 | $109.65 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
BCBS South Carolina Setting Facility Modifier None Typical Low $257.04 Median $549.54 Typical High $794.33 | Facility | None | $257.04 | $549.54 | $794.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $186.21 | Professional | None | $120.23 | $151.36 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $416.87 Typical High $831.76 | Facility | None | $354.81 | $416.87 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $269.15 | Professional | None | $120.23 | $147.91 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Medcost Setting Facility Modifier None Typical Low $102.33 Median $128.82 Typical High $407.38 | Facility | None | $102.33 | $128.82 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $213.80 | Professional | None | $123.03 | $199.53 | $213.80 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $257.04 | Professional | None | $131.83 | $194.98 | $257.04 |
United Setting Facility Modifier None Typical Low $562.34 Median $691.83 Typical High $891.25 | Facility | None | $562.34 | $691.83 | $891.25 |
United Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $239.88 | Professional | None | $102.33 | $144.54 | $239.88 |
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 $54.95 Median $54.95 Typical High $61.66 | Professional | 52 · Reduced service | $54.95 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $24.55 | Professional | 53 · Discontinued | $21.88 | $21.88 | $24.55 |
Aetna Setting Professional Modifier FX · Film X-ray Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | FX · Film X-ray | $89.13 | $89.13 | $100.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $102.33 Typical High $112.20 | Professional | 51 · Multiple procedures | $61.66 | $102.33 | $112.20 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $24.55 Median $40.74 Typical High $45.71 | Professional | 80 · Assistant surgeon | $24.55 | $40.74 | $45.71 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.38 Median $28.84 Typical High $31.62 | Professional | 81 · Minimal assistant surgeon | $17.38 | $28.84 | $31.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.38 Median $28.84 Typical High $31.62 | Professional | 82 · Assistant surgeon, no resident | $17.38 | $28.84 | $31.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $28.84 Typical High $31.62 | Professional | AS · PA/NP assist | $17.38 | $28.84 | $31.62 |
Where South Carolina sits
The same service costs 4.1 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· 22nd of 51
$178
AK $490NY $120
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.