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 $11.75 Median $14.79 Typical High $20.89 | Facility | None | $11.75 | $14.79 | $20.89 |
Aetna Setting Professional Modifier None (both parts) Typical Low $11.75 Median $11.75 Typical High $14.13 | Professional | None (both parts) | $11.75 | $11.75 | $14.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $19.50 Median $58.88 Typical High $177.83 | Facility | None | $19.50 | $58.88 | $177.83 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $11.22 Median $14.79 Typical High $19.05 | Professional | None (both parts) | $11.22 | $14.79 | $19.05 |
Cigna Setting Professional Modifier None (both parts) Typical Low $12.02 Median $12.88 Typical High $18.62 | Professional | None (both parts) | $12.02 | $12.88 | $18.62 |
Medcost Setting Facility Modifier None Typical Low $11.75 Median $26.30 Typical High $47.86 | Facility | None | $11.75 | $26.30 | $47.86 |
Medcost Setting Professional Modifier None (both parts) Typical Low $14.13 Median $18.62 Typical High $25.70 | Professional | None (both parts) | $14.13 | $18.62 | $25.70 |
United Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $17.38 | Facility | None | $15.85 | $15.85 | $17.38 |
United Setting Professional Modifier None (both parts) Typical Low $13.80 Median $15.85 Typical High $21.88 | Professional | None (both parts) | $13.80 | $15.85 | $21.88 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $19.95 Median $20.89 Typical High $20.89 | Professional | GO · Occupational therapy plan | $19.95 | $20.89 | $20.89 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $6.31 Median $7.41 Typical High $11.22 | Professional | 26 · Professional part | $6.31 | $7.41 | $11.22 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $7.08 Median $9.33 Typical High $12.88 | Professional | 51 · Multiple procedures | $7.08 | $9.33 | $12.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.82 Median $3.72 Typical High $5.25 | Professional | 80 · Assistant surgeon | $2.82 | $3.72 | $5.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.95 Median $2.63 Typical High $3.63 | Professional | 81 · Minimal assistant surgeon | $1.95 | $2.63 | $3.63 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.95 Median $2.63 Typical High $3.63 | Professional | 82 · Assistant surgeon, no resident | $1.95 | $2.63 | $3.63 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.95 Median $2.63 Typical High $3.63 | Professional | AS · PA/NP assist | $1.95 | $2.63 | $3.63 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $9.55 Median $11.22 Typical High $16.98 | Professional | TC · Technical part | $9.55 | $11.22 | $16.98 |
Where South Carolina sits
The same service costs 2.7 times more in Alaska than in Ohio. 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· 41st of 51
$14.79
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.