How much rates vary
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 $3.89 Median $3.89 Typical High $15.14 | Facility | None | $3.89 | $3.89 | $15.14 |
Aetna Setting Professional Modifier None (both parts) Typical Low $3.89 Median $3.89 Typical High $5.89 | Professional | None (both parts) | $3.89 | $3.89 | $5.89 |
BCBS South Carolina Setting Facility Modifier None Typical Low $10.72 Median $26.92 Typical High $104.71 | Facility | None | $10.72 | $26.92 | $104.71 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $5.62 Median $6.03 Typical High $15.85 | Professional | None (both parts) | $5.62 | $6.03 | $15.85 |
Cigna Setting Professional Modifier None (both parts) Typical Low $4.68 Median $5.50 Typical High $7.76 | Professional | None (both parts) | $4.68 | $5.50 | $7.76 |
Medcost Setting Facility Modifier None Typical Low $3.89 Median $12.30 Typical High $15.85 | Facility | None | $3.89 | $12.30 | $15.85 |
Medcost Setting Professional Modifier None (both parts) Typical Low $6.03 Median $8.32 Typical High $22.91 | Professional | None (both parts) | $6.03 | $8.32 | $22.91 |
United Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $6.61 | Facility | None | $6.03 | $6.03 | $6.61 |
United Setting Professional Modifier None (both parts) Typical Low $4.79 Median $5.89 Typical High $10.23 | Professional | None (both parts) | $4.79 | $5.89 | $10.23 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | GO · Occupational therapy plan | $8.32 | $8.32 | $8.32 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $2.40 Median $3.31 Typical High $9.12 | Professional | 26 · Professional part | $2.40 | $3.31 | $9.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.02 Median $4.07 Typical High $11.48 | Professional | 51 · Multiple procedures | $3.02 | $4.07 | $11.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.20 Median $1.66 Typical High $4.57 | Professional | 80 · Assistant surgeon | $1.20 | $1.66 | $4.57 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.83 Median $1.15 Typical High $3.24 | Professional | 81 · Minimal assistant surgeon | $0.83 | $1.15 | $3.24 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.83 Median $1.15 Typical High $3.24 | Professional | 82 · Assistant surgeon, no resident | $0.83 | $1.15 | $3.24 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.83 Median $1.15 Typical High $3.24 | Professional | AS · PA/NP assist | $0.83 | $1.15 | $3.24 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $3.63 Median $4.90 Typical High $13.80 | Professional | TC · Technical part | $3.63 | $4.90 | $13.80 |
Where South Carolina sits
The same service costs 2.6 times more in North Dakota than in Missouri. 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· 35th of 51
$6.03
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.