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 $70.79 Median $85.11 Typical High $154.88 | Facility | None | $70.79 | $85.11 | $154.88 |
Aetna Setting Professional Modifier None (both parts) Typical Low $70.79 Median $70.79 Typical High $85.11 | Professional | None (both parts) | $70.79 | $70.79 | $85.11 |
BCBS South Carolina Setting Facility Modifier None Typical Low $63.10 Median $165.96 Typical High $426.58 | Facility | None | $63.10 | $165.96 | $426.58 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $40.74 Median $52.48 Typical High $97.72 | Professional | None (both parts) | $40.74 | $52.48 | $97.72 |
Cigna Setting Professional Modifier None (both parts) Typical Low $61.66 Median $66.07 Typical High $81.28 | Professional | None (both parts) | $61.66 | $66.07 | $81.28 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $85.11 Typical High $275.42 | Facility | None | $70.79 | $85.11 | $275.42 |
Medcost Setting Professional Modifier None (both parts) Typical Low $77.62 Median $107.15 Typical High $117.49 | Professional | None (both parts) | $77.62 | $107.15 | $117.49 |
Molina Setting Professional Modifier None (both parts) Typical Low $95.50 Median $123.03 Typical High $190.55 | Professional | None (both parts) | $95.50 | $123.03 | $190.55 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $109.65 | Facility | None | $100.00 | $100.00 | $109.65 |
United Setting Professional Modifier None (both parts) Typical Low $70.79 Median $81.28 Typical High $93.33 | Professional | None (both parts) | $70.79 | $81.28 | $93.33 |
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 $77.62 Median $77.62 Typical High $177.83 | Professional | GO · Occupational therapy plan | $77.62 | $77.62 | $177.83 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $38.90 Median $42.66 Typical High $67.61 | Professional | 26 · Professional part | $38.90 | $42.66 | $67.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $53.70 Typical High $72.44 | Professional | 51 · Multiple procedures | $48.98 | $53.70 | $72.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.50 Median $21.38 Typical High $28.84 | Professional | 80 · Assistant surgeon | $19.50 | $21.38 | $28.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.49 Median $14.79 Typical High $20.42 | Professional | 81 · Minimal assistant surgeon | $13.49 | $14.79 | $20.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.49 Median $14.79 Typical High $20.42 | Professional | 82 · Assistant surgeon, no resident | $13.49 | $14.79 | $20.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.49 Median $14.79 Typical High $20.42 | Professional | AS · PA/NP assist | $13.49 | $14.79 | $20.42 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $58.88 Median $63.10 Typical High $102.33 | Professional | TC · Technical part | $58.88 | $63.10 | $102.33 |
Where South Carolina sits
The same service costs 3.3 times more in Alaska than in Florida. 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· 48th of 51
$66.07
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.