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 $20.89 Median $32.36 Typical High $81.28 | Facility | None | $20.89 | $32.36 | $81.28 |
Aetna Setting Professional Modifier None (both parts) Typical Low $20.89 Median $20.89 Typical High $26.92 | Professional | None (both parts) | $20.89 | $20.89 | $26.92 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $22.39 Median $22.39 Typical High $34.67 | Professional | GP · Physical therapy plan | $22.39 | $22.39 | $34.67 |
BCBS South Carolina Setting Facility Modifier None Typical Low $38.02 Median $81.28 Typical High $141.25 | Facility | None | $38.02 | $81.28 | $141.25 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $22.39 Median $22.91 Typical High $28.18 | Professional | None (both parts) | $22.39 | $22.91 | $28.18 |
Cigna Setting Professional Modifier None (both parts) Typical Low $20.89 Median $21.88 Typical High $26.30 | Professional | None (both parts) | $20.89 | $21.88 | $26.30 |
Medcost Setting Facility Modifier None Typical Low $20.89 Median $36.31 Typical High $81.28 | Facility | None | $20.89 | $36.31 | $81.28 |
Medcost Setting Professional Modifier None (both parts) Typical Low $25.70 Median $30.20 Typical High $39.81 | Professional | None (both parts) | $25.70 | $30.20 | $39.81 |
United Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $31.62 | Facility | None | $28.84 | $28.84 | $31.62 |
United Setting Professional Modifier None (both parts) Typical Low $23.44 Median $27.54 Typical High $30.90 | Professional | None (both parts) | $23.44 | $27.54 | $30.90 |
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 $22.39 Median $22.39 Typical High $38.90 | Professional | GO · Occupational therapy plan | $22.39 | $22.39 | $38.90 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $11.22 Median $12.02 Typical High $20.42 | Professional | 26 · Professional part | $11.22 | $12.02 | $20.42 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $13.49 Median $15.14 Typical High $25.70 | Professional | 51 · Multiple procedures | $13.49 | $15.14 | $25.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.37 Median $6.03 Typical High $10.23 | Professional | 80 · Assistant surgeon | $5.37 | $6.03 | $10.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.80 Median $4.17 Typical High $7.08 | Professional | 81 · Minimal assistant surgeon | $3.80 | $4.17 | $7.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.80 Median $4.17 Typical High $7.08 | Professional | 82 · Assistant surgeon, no resident | $3.80 | $4.17 | $7.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.80 Median $4.17 Typical High $7.08 | Professional | AS · PA/NP assist | $3.80 | $4.17 | $7.08 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $16.60 Median $18.20 Typical High $30.90 | Professional | TC · Technical part | $16.60 | $18.20 | $30.90 |
Where South Carolina sits
The same service costs 3.5 times more in Minnesota 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· 45th of 51
$22.91
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.