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 $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier None (both parts) Typical Low $23.44 Median $23.44 Typical High $28.18 | Professional | None (both parts) | $23.44 | $23.44 | $28.18 |
BCBS South Carolina Setting Facility Modifier None Typical Low $37.15 Median $77.62 Typical High $173.78 | Facility | None | $37.15 | $77.62 | $173.78 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $21.38 Median $30.90 Typical High $32.36 | Professional | None (both parts) | $21.38 | $30.90 | $32.36 |
Cigna Setting Professional Modifier None (both parts) Typical Low $22.39 Median $22.91 Typical High $29.51 | Professional | None (both parts) | $22.39 | $22.91 | $29.51 |
Medcost Setting Facility Modifier None Typical Low $23.44 Median $26.92 Typical High $93.33 | Facility | None | $23.44 | $26.92 | $93.33 |
Medcost Setting Professional Modifier None (both parts) Typical Low $28.84 Median $30.20 Typical High $45.71 | Professional | None (both parts) | $28.84 | $30.20 | $45.71 |
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 $33.88 Median $33.88 Typical High $37.15 | Facility | None | $33.88 | $33.88 | $37.15 |
United Setting Professional Modifier None (both parts) Typical Low $25.12 Median $30.20 Typical High $33.88 | Professional | None (both parts) | $25.12 | $30.20 | $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 $25.70 Median $25.70 Typical High $37.15 | Professional | GP · Physical therapy plan | $25.70 | $25.70 | $37.15 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $12.02 Median $12.02 Typical High $22.91 | Professional | 26 · Professional part | $12.02 | $12.02 | $22.91 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.45 Median $15.14 Typical High $24.55 | Professional | 51 · Multiple procedures | $14.45 | $15.14 | $24.55 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.75 Median $6.03 Typical High $9.77 | Professional | 80 · Assistant surgeon | $5.75 | $6.03 | $9.77 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.98 Median $4.27 Typical High $6.76 | Professional | 81 · Minimal assistant surgeon | $3.98 | $4.27 | $6.76 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.98 Median $4.27 Typical High $6.76 | Professional | 82 · Assistant surgeon, no resident | $3.98 | $4.27 | $6.76 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.98 Median $4.27 Typical High $6.76 | Professional | AS · PA/NP assist | $3.98 | $4.27 | $6.76 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $18.20 Median $18.20 Typical High $33.88 | Professional | TC · Technical part | $18.20 | $18.20 | $33.88 |
Where South Carolina sits
The same service costs 3.2 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· 30th of 51
$30.90
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.