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 $33.88 Median $33.88 Typical High $70.79 | Facility | None | $33.88 | $33.88 | $70.79 |
Aetna Setting Professional Modifier None (both parts) Typical Low $29.51 Median $33.88 Typical High $40.74 | Professional | None (both parts) | $29.51 | $33.88 | $40.74 |
BCBS South Carolina Setting Facility Modifier None Typical Low $36.31 Median $61.66 Typical High $114.82 | Facility | None | $36.31 | $61.66 | $114.82 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $43.65 Median $46.77 Typical High $46.77 | Professional | None (both parts) | $43.65 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None (both parts) Typical Low $24.55 Median $24.55 Typical High $40.74 | Professional | None (both parts) | $24.55 | $24.55 | $40.74 |
Medcost Setting Facility Modifier None Typical Low $33.88 Median $45.71 Typical High $128.82 | Facility | None | $33.88 | $45.71 | $128.82 |
Medcost Setting Professional Modifier None (both parts) Typical Low $31.62 Median $34.67 Typical High $54.95 | Professional | None (both parts) | $31.62 | $34.67 | $54.95 |
Molina Setting Professional Modifier None (both parts) Typical Low $54.95 Median $77.62 Typical High $125.89 | Professional | None (both parts) | $54.95 | $77.62 | $125.89 |
United Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $51.29 | Facility | None | $45.71 | $45.71 | $51.29 |
United Setting Professional Modifier None (both parts) Typical Low $25.70 Median $36.31 Typical High $46.77 | Professional | None (both parts) | $25.70 | $36.31 | $46.77 |
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 $61.66 Median $61.66 Typical High $63.10 | Professional | GO · Occupational therapy plan | $61.66 | $61.66 | $63.10 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $12.88 Median $13.80 Typical High $32.36 | Professional | 26 · Professional part | $12.88 | $13.80 | $32.36 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.85 Median $17.38 Typical High $34.67 | Professional | 51 · Multiple procedures | $15.85 | $17.38 | $34.67 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.31 Median $6.92 Typical High $13.80 | Professional | 80 · Assistant surgeon | $6.31 | $6.92 | $13.80 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.47 Median $4.90 Typical High $9.77 | Professional | 81 · Minimal assistant surgeon | $4.47 | $4.90 | $9.77 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.47 Median $4.90 Typical High $9.77 | Professional | 82 · Assistant surgeon, no resident | $4.47 | $4.90 | $9.77 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.47 Median $4.90 Typical High $9.77 | Professional | AS · PA/NP assist | $4.47 | $4.90 | $9.77 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $19.05 Median $20.89 Typical High $48.98 | Professional | TC · Technical part | $19.05 | $20.89 | $48.98 |
Where South Carolina sits
The same service costs 3.5 times more in Alaska than in Virginia. 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· 24th of 51
$43.65
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.