How much rates vary
Facilitymedian $126 · 10th to 90th $78 to $347Professionalmedian $81 · 10th to 90th $34 to $100
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 $87.10 Median $102.33 Typical High $128.82 | Facility | None | $87.10 | $102.33 | $128.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $83.18 Median $87.10 Typical High $89.13 | Professional | None (both parts) | $83.18 | $87.10 | $89.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $75.86 Median $138.04 Typical High $346.74 | Facility | None | $75.86 | $138.04 | $346.74 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $33.88 Median $45.71 Typical High $83.18 | Professional | None (both parts) | $33.88 | $45.71 | $83.18 |
Cigna Setting Professional Modifier None (both parts) Typical Low $27.54 Median $83.18 Typical High $102.33 | Professional | None (both parts) | $27.54 | $83.18 | $102.33 |
Medcost Setting Facility Modifier None Typical Low $27.54 Median $89.13 Typical High $234.42 | Facility | None | $27.54 | $89.13 | $234.42 |
Medcost Setting Professional Modifier None (both parts) Typical Low $66.07 Median $97.72 Typical High $102.33 | Professional | None (both parts) | $66.07 | $97.72 | $102.33 |
Molina Setting Professional Modifier None (both parts) Typical Low $63.10 Median $79.43 Typical High $125.89 | Professional | None (both parts) | $63.10 | $79.43 | $125.89 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $93.33 | Facility | None | $85.11 | $85.11 | $93.33 |
United Setting Professional Modifier None (both parts) Typical Low $27.54 Median $81.28 Typical High $112.20 | Professional | None (both parts) | $27.54 | $81.28 | $112.20 |
12 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 $41.69 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $41.69 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $16.60 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $12.59 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.32 | $8.71 | $8.71 |
Ambetter Setting Professional Modifier GN · Speech therapy plan + HA · Child/adolescent program Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | GN · Speech therapy plan + HA · Child/adolescent program | $64.57 | $64.57 | $64.57 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $32.36 Median $40.74 Typical High $57.54 | Professional | 26 · Professional part | $32.36 | $40.74 | $57.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.11 Median $51.29 Typical High $61.66 | Professional | 51 · Multiple procedures | $33.11 | $51.29 | $61.66 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.18 Median $20.42 Typical High $24.55 | Professional | 80 · Assistant surgeon | $13.18 | $20.42 | $24.55 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.12 Median $14.45 Typical High $17.38 | Professional | 81 · Minimal assistant surgeon | $9.12 | $14.45 | $17.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.12 Median $14.45 Typical High $17.38 | Professional | 82 · Assistant surgeon, no resident | $9.12 | $14.45 | $17.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.12 Median $14.45 Typical High $17.38 | Professional | AS · PA/NP assist | $9.12 | $14.45 | $17.38 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $47.86 Median $61.66 Typical High $85.11 | Professional | TC · Technical part | $47.86 | $61.66 | $85.11 |
Where South Carolina sits
The same service costs 2.9 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· 38th of 51
$81.28
AK $186UT $64.57
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.