How much rates vary
Facilitymedian $81 · 10th to 90th $31 to $174Professionalmedian $26 · 10th to 90th $19 to $29
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 $19.05 Median $23.99 Typical High $42.66 | Facility | None | $19.05 | $23.99 | $42.66 |
Aetna Setting Professional Modifier None (both parts) Typical Low $19.05 Median $19.05 Typical High $25.12 | Professional | None (both parts) | $19.05 | $19.05 | $25.12 |
BCBS South Carolina Setting Facility Modifier None Typical Low $40.74 Median $93.33 Typical High $181.97 | Facility | None | $40.74 | $93.33 | $181.97 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $19.05 Median $26.30 Typical High $28.84 | Professional | None (both parts) | $19.05 | $26.30 | $28.84 |
Cigna Setting Professional Modifier None (both parts) Typical Low $19.05 Median $20.42 Typical High $24.55 | Professional | None (both parts) | $19.05 | $20.42 | $24.55 |
Medcost Setting Facility Modifier None Typical Low $19.05 Median $33.88 Typical High $74.13 | Facility | None | $19.05 | $33.88 | $74.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $25.70 Median $28.18 Typical High $36.31 | Professional | None (both parts) | $25.70 | $28.18 | $36.31 |
United Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $30.20 | Facility | None | $27.54 | $27.54 | $30.20 |
United Setting Professional Modifier None (both parts) Typical Low $21.88 Median $25.70 Typical High $28.84 | Professional | None (both parts) | $21.88 | $25.70 | $28.84 |
11 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 CQ · PT assistant Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | CQ · PT assistant | $19.05 | $19.05 | $19.05 |
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $21.38 Median $21.38 Typical High $37.15 | Professional | GO · Occupational therapy plan | $21.38 | $21.38 | $37.15 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $21.38 Median $21.38 Typical High $38.90 | Professional | GP · Physical therapy plan | $21.38 | $21.38 | $38.90 |
Ambetter Setting Professional Modifier XS · Separate structure Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | XS · Separate structure | $26.92 | $26.92 | $26.92 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $10.47 Median $11.22 Typical High $18.20 | Professional | 26 · Professional part | $10.47 | $11.22 | $18.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.88 Median $14.13 Typical High $19.50 | Professional | 51 · Multiple procedures | $12.88 | $14.13 | $19.50 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.25 Median $5.62 Typical High $7.94 | Professional | 80 · Assistant surgeon | $5.25 | $5.62 | $7.94 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.63 Median $3.89 Typical High $5.50 | Professional | 81 · Minimal assistant surgeon | $3.63 | $3.89 | $5.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.63 Median $3.89 Typical High $5.50 | Professional | 82 · Assistant surgeon, no resident | $3.63 | $3.89 | $5.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.63 Median $3.89 Typical High $5.50 | Professional | AS · PA/NP assist | $3.63 | $3.89 | $5.50 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $15.49 Median $16.98 Typical High $27.54 | Professional | TC · Technical part | $15.49 | $16.98 | $27.54 |
Where South Carolina sits
The same service costs 3.0 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· 26th of 51
$26.30
MN $53.70OH $17.78
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.