How much rates vary
Facilitymedian $66 · 10th to 90th $52 to $166Professionalmedian $52 · 10th to 90th $37 to $56
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 $53.70 Median $53.70 Typical High $67.61 | Facility | None | $53.70 | $53.70 | $67.61 |
Aetna Setting Professional Modifier None (both parts) Typical Low $52.48 Median $53.70 Typical High $53.70 | Professional | None (both parts) | $52.48 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.30 | $26.92 | $26.92 |
BCBS South Carolina Setting Facility Modifier None Typical Low $52.48 Median $69.18 Typical High $173.78 | Facility | None | $52.48 | $69.18 | $173.78 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $47.86 Median $52.48 Typical High $52.48 | Professional | None (both parts) | $47.86 | $52.48 | $52.48 |
Cigna Setting Professional Modifier None (both parts) Typical Low $33.88 Median $40.74 Typical High $43.65 | Professional | None (both parts) | $33.88 | $40.74 | $43.65 |
Medcost Setting Facility Modifier None Typical Low $53.70 Median $58.88 Typical High $141.25 | Facility | None | $53.70 | $58.88 | $141.25 |
Medcost Setting Professional Modifier None (both parts) Typical Low $40.74 Median $54.95 Typical High $60.26 | Professional | None (both parts) | $40.74 | $54.95 | $60.26 |
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 $50.12 Median $50.12 Typical High $54.95 | Facility | None | $50.12 | $50.12 | $54.95 |
United Setting Professional Modifier None (both parts) Typical Low $39.81 Median $45.71 Typical High $56.23 | Professional | None (both parts) | $39.81 | $45.71 | $56.23 |
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 $67.61 Typical High $70.79 | Professional | GO · Occupational therapy plan | $61.66 | $67.61 | $70.79 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $21.88 Median $21.88 Typical High $35.48 | Professional | 26 · Professional part | $21.88 | $21.88 | $35.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $27.54 Median $27.54 Typical High $38.02 | Professional | 51 · Multiple procedures | $27.54 | $27.54 | $38.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.96 Median $10.96 Typical High $15.14 | Professional | 80 · Assistant surgeon | $10.96 | $10.96 | $15.14 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.76 Median $7.76 Typical High $10.47 | Professional | 81 · Minimal assistant surgeon | $7.76 | $7.76 | $10.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.76 Median $7.76 Typical High $10.47 | Professional | 82 · Assistant surgeon, no resident | $7.76 | $7.76 | $10.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.76 Median $7.76 Typical High $10.47 | Professional | AS · PA/NP assist | $7.76 | $7.76 | $10.47 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $33.11 Median $33.11 Typical High $52.48 | Professional | TC · Technical part | $33.11 | $33.11 | $52.48 |
Where South Carolina sits
The same service costs 3.5 times more in Alaska than in Utah. 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
$52.48
AK $110UT $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.