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 $22.91 Median $28.84 Typical High $50.12 | Facility | None | $22.91 | $28.84 | $50.12 |
Aetna Setting Professional Modifier None (both parts) Typical Low $22.91 Median $22.91 Typical High $28.18 | Professional | None (both parts) | $22.91 | $22.91 | $28.18 |
BCBS South Carolina Setting Facility Modifier None Typical Low $24.55 Median $52.48 Typical High $117.49 | Facility | None | $24.55 | $52.48 | $117.49 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $30.90 Median $32.36 Typical High $32.36 | Professional | None (both parts) | $30.90 | $32.36 | $32.36 |
Cigna Setting Professional Modifier None (both parts) Typical Low $22.91 Median $23.44 Typical High $28.84 | Professional | None (both parts) | $22.91 | $23.44 | $28.84 |
Medcost Setting Facility Modifier None Typical Low $22.91 Median $39.81 Typical High $89.13 | Facility | None | $22.91 | $39.81 | $89.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $28.84 Median $32.36 Typical High $41.69 | Professional | None (both parts) | $28.84 | $32.36 | $41.69 |
Molina Setting Professional Modifier None (both parts) Typical Low $29.51 Median $39.81 Typical High $61.66 | Professional | None (both parts) | $29.51 | $39.81 | $61.66 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $35.48 | Facility | None | $32.36 | $32.36 | $35.48 |
United Setting Professional Modifier None (both parts) Typical Low $25.12 Median $29.51 Typical High $33.88 | Professional | None (both parts) | $25.12 | $29.51 | $33.88 |
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 GP · Physical therapy plan Typical Low $25.12 Median $25.12 Typical High $38.90 | Professional | GP · Physical therapy plan | $25.12 | $25.12 | $38.90 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $12.30 Median $12.88 Typical High $21.88 | Professional | 26 · Professional part | $12.30 | $12.88 | $21.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.45 Median $15.85 Typical High $23.44 | Professional | 51 · Multiple procedures | $14.45 | $15.85 | $23.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.75 Median $6.46 Typical High $9.55 | Professional | 80 · Assistant surgeon | $5.75 | $6.46 | $9.55 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.07 Median $4.47 Typical High $6.61 | Professional | 81 · Minimal assistant surgeon | $4.07 | $4.47 | $6.61 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.07 Median $4.47 Typical High $6.61 | Professional | 82 · Assistant surgeon, no resident | $4.07 | $4.47 | $6.61 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.07 Median $4.47 Typical High $6.61 | Professional | AS · PA/NP assist | $4.07 | $4.47 | $6.61 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $18.62 Median $19.05 Typical High $33.11 | Professional | TC · Technical part | $18.62 | $19.05 | $33.11 |
Where South Carolina sits
The same service costs 3.0 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· 26th of 51
$31.62
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.