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 $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $18.62 Typical High $20.89 | Professional | None | $17.78 | $18.62 | $20.89 |
Ambetter Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $25.70 | Professional | None | $22.91 | $22.91 | $25.70 |
BCBS South Carolina Setting Facility Modifier None Typical Low $128.82 Median $169.82 Typical High $407.38 | Facility | None | $128.82 | $169.82 | $407.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $19.05 Typical High $30.20 | Professional | None | $18.62 | $19.05 | $30.20 |
Medcost Setting Facility Modifier None Typical Low $18.62 Median $20.42 Typical High $52.48 | Facility | None | $18.62 | $20.42 | $52.48 |
Medcost Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $38.90 Typical High $60.26 | Professional | None | $29.51 | $38.90 | $60.26 |
United Setting Facility Modifier None Typical Low $562.34 Median $676.08 Typical High $891.25 | Facility | None | $562.34 | $676.08 | $891.25 |
United Setting Professional Modifier None Typical Low $16.22 Median $19.05 Typical High $26.92 | Professional | None | $16.22 | $19.05 | $26.92 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $8.91 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.55 | $3.72 | $3.72 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | GP · Physical therapy plan | $15.85 | $15.85 | $15.85 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $10.47 Median $10.47 Typical High $13.18 | Professional | 51 · Multiple procedures | $10.47 | $10.47 | $13.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.17 Median $4.17 Typical High $5.25 | Professional | 80 · Assistant surgeon | $4.17 | $4.17 | $5.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.95 Median $2.95 Typical High $3.63 | Professional | 81 · Minimal assistant surgeon | $2.95 | $2.95 | $3.63 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.95 Median $2.95 Typical High $3.63 | Professional | 82 · Assistant surgeon, no resident | $2.95 | $2.95 | $3.63 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.95 Median $2.95 Typical High $3.63 | Professional | AS · PA/NP assist | $2.95 | $2.95 | $3.63 |
Where South Carolina sits
The same service costs 2.3 times more in Minnesota than in Kentucky. 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· 36th of 51
$19.95
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.