How much rates vary
Facilitymedian $31 · 10th to 90th $23 to $37Professionalmedian $30 · 10th to 90th $23 to $40
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 $22.39 Median $25.70 Typical High $30.90 | Facility | None | $22.39 | $25.70 | $30.90 |
Aetna Setting Professional Modifier None (both parts) Typical Low $22.39 Median $26.30 Typical High $31.62 | Professional | None (both parts) | $22.39 | $26.30 | $31.62 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $26.30 Median $30.90 Typical High $52.48 | Professional | None (both parts) | $26.30 | $30.90 | $52.48 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $38.90 Median $38.90 Typical High $39.81 | Professional | None (both parts) | $38.90 | $38.90 | $39.81 |
Cigna Setting Professional Modifier None (both parts) Typical Low $32.36 Median $34.67 Typical High $50.12 | Professional | None (both parts) | $32.36 | $34.67 | $50.12 |
Medcost Setting Facility Modifier None Typical Low $30.20 Median $33.11 Typical High $41.69 | Facility | None | $30.20 | $33.11 | $41.69 |
Medcost Setting Professional Modifier None (both parts) Typical Low $34.67 Median $34.67 Typical High $36.31 | Professional | None (both parts) | $34.67 | $34.67 | $36.31 |
Molina Setting Professional Modifier None (both parts) Typical Low $15.85 Median $23.99 Typical High $30.20 | Professional | None (both parts) | $15.85 | $23.99 | $30.20 |
United Setting Professional Modifier None (both parts) Typical Low $26.92 Median $33.11 Typical High $43.65 | Professional | None (both parts) | $26.92 | $33.11 | $43.65 |
11 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 $15.14 Median $15.14 Typical High $15.49 | Professional | 52 · Reduced service | $15.14 | $15.14 | $15.49 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 25 · Same-day visit | $56.23 | $56.23 | $56.23 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $38.90 Median $39.81 Typical High $40.74 | Professional | 29 | $38.90 | $39.81 | $40.74 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $13.80 Median $13.80 Typical High $20.89 | Professional | 26 · Professional part | $13.80 | $13.80 | $20.89 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $51.29 Median $51.29 Typical High $67.61 | Professional | 50 · Both sides | $51.29 | $51.29 | $67.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $17.38 Median $17.38 Typical High $22.39 | Professional | 51 · Multiple procedures | $17.38 | $17.38 | $22.39 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.92 Median $6.92 Typical High $8.91 | Professional | 80 · Assistant surgeon | $6.92 | $6.92 | $8.91 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.79 Median $4.79 Typical High $6.31 | Professional | 81 · Minimal assistant surgeon | $4.79 | $4.79 | $6.31 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.79 Median $4.79 Typical High $6.31 | Professional | 82 · Assistant surgeon, no resident | $4.79 | $4.79 | $6.31 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.79 Median $4.79 Typical High $6.31 | Professional | AS · PA/NP assist | $4.79 | $4.79 | $6.31 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $20.89 Median $20.89 Typical High $31.62 | Professional | TC · Technical part | $20.89 | $20.89 | $31.62 |
Where South Carolina sits
The same service costs 2.5 times more in Alaska than in New York. 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
$30.20
AK $60.26NY $23.99
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.