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 $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $15.14 | Professional | None | $13.80 | $13.80 | $15.14 |
BCBS South Carolina Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $89.13 | Facility | None | $54.95 | $54.95 | $89.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $17.38 Median $95.50 Typical High $117.49 | Professional | None | $17.38 | $95.50 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $79.43 Typical High $144.54 | Professional | None | $17.78 | $79.43 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Medcost Setting Facility Modifier None Typical Low $13.80 Median $18.62 Typical High $107.15 | Facility | None | $13.80 | $18.62 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $20.89 Median $117.49 Typical High $125.89 | Professional | None | $20.89 | $117.49 | $125.89 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $48.98 Typical High $64.57 | Professional | None | $33.11 | $48.98 | $64.57 |
United Setting Professional Modifier None Typical Low $15.14 Median $26.30 Typical High $131.83 | Professional | None | $15.14 | $26.30 | $131.83 |
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 $6.92 Median $6.92 Typical High $7.59 | Professional | 52 · Reduced service | $6.92 | $6.92 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.75 Typical High $3.02 | Professional | 53 · Discontinued | $2.75 | $2.75 | $3.02 |
Aetna Setting Professional Modifier FX · Film X-ray Typical Low $10.96 Median $10.96 Typical High $12.02 | Professional | FX · Film X-ray | $10.96 | $10.96 | $12.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.59 Median $58.88 Typical High $63.10 | Professional | 51 · Multiple procedures | $12.59 | $58.88 | $63.10 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.01 Median $23.44 Typical High $25.12 | Professional | 80 · Assistant surgeon | $5.01 | $23.44 | $25.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.47 Median $16.22 Typical High $17.78 | Professional | 81 · Minimal assistant surgeon | $3.47 | $16.22 | $17.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.47 Median $16.22 Typical High $17.78 | Professional | 82 · Assistant surgeon, no resident | $3.47 | $16.22 | $17.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.47 Median $16.22 Typical High $17.78 | Professional | AS · PA/NP assist | $3.47 | $16.22 | $17.78 |
Where South Carolina sits
The same service costs 5.5 times more in Alabama than in Pennsylvania. 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· 11th of 51
$52.48
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.