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 $10.00 Median $12.59 Typical High $21.88 | Facility | None | $10.00 | $12.59 | $21.88 |
Aetna Setting Professional Modifier None (both parts) Typical Low $10.00 Median $10.00 Typical High $13.18 | Professional | None (both parts) | $10.00 | $10.00 | $13.18 |
BCBS South Carolina Setting Facility Modifier None Typical Low $20.89 Median $53.70 Typical High $128.82 | Facility | None | $20.89 | $53.70 | $128.82 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $12.02 Median $13.80 Typical High $15.14 | Professional | None (both parts) | $12.02 | $13.80 | $15.14 |
Cigna Setting Professional Modifier None (both parts) Typical Low $8.91 Median $9.33 Typical High $12.02 | Professional | None (both parts) | $8.91 | $9.33 | $12.02 |
Medcost Setting Facility Modifier None Typical Low $10.00 Median $14.45 Typical High $38.02 | Facility | None | $10.00 | $14.45 | $38.02 |
Medcost Setting Professional Modifier None (both parts) Typical Low $12.02 Median $12.88 Typical High $21.38 | Professional | None (both parts) | $12.02 | $12.88 | $21.38 |
United Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $15.85 | Facility | None | $14.45 | $14.45 | $15.85 |
United Setting Professional Modifier None (both parts) Typical Low $10.96 Median $12.59 Typical High $14.79 | Professional | None (both parts) | $10.96 | $12.59 | $14.79 |
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 GP · Physical therapy plan Typical Low $10.96 Median $13.80 Typical High $23.44 | Professional | GP · Physical therapy plan | $10.96 | $13.80 | $23.44 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $4.90 Median $5.25 Typical High $9.77 | Professional | 26 · Professional part | $4.90 | $5.25 | $9.77 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.03 Median $6.46 Typical High $10.96 | Professional | 51 · Multiple procedures | $6.03 | $6.46 | $10.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.40 Median $2.57 Typical High $4.37 | Professional | 80 · Assistant surgeon | $2.40 | $2.57 | $4.37 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.70 Median $1.82 Typical High $3.09 | Professional | 81 · Minimal assistant surgeon | $1.70 | $1.82 | $3.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.70 Median $1.82 Typical High $3.09 | Professional | 82 · Assistant surgeon, no resident | $1.70 | $1.82 | $3.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.70 Median $1.82 Typical High $3.09 | Professional | AS · PA/NP assist | $1.70 | $1.82 | $3.09 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $7.41 Median $7.76 Typical High $14.45 | Professional | TC · Technical part | $7.41 | $7.76 | $14.45 |
Where South Carolina sits
The same service costs 3.2 times more in Alaska than in Virginia. 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
$12.02
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.