How much rates vary
Facilitymedian $1,288 · 10th to 90th $110 to $2,570Professionalmedian $85 · 10th to 90th $68 to $138
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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None (both parts) Typical Low $69.18 Median $83.18 Typical High $83.18 | Professional | None (both parts) | $69.18 | $83.18 | $83.18 |
BCBS South Carolina Setting Facility Modifier None Typical Low $776.25 Median $1,513.56 Typical High $2,754.23 | Facility | None | $776.25 | $1,513.56 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $524.81 Typical High $870.96 | Facility | None | $436.52 | $524.81 | $870.96 |
Cigna Setting Professional Modifier None (both parts) Typical Low $83.18 Median $87.10 Typical High $162.18 | Professional | None (both parts) | $83.18 | $87.10 | $162.18 |
Medcost Setting Facility Modifier None Typical Low $58.88 Median $83.18 Typical High $446.68 | Facility | None | $58.88 | $83.18 | $446.68 |
Medcost Setting Professional Modifier None (both parts) Typical Low $83.18 Median $97.72 Typical High $109.65 | Professional | None (both parts) | $83.18 | $97.72 | $109.65 |
Molina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None (both parts) | $30.20 | $30.20 | $30.20 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None (both parts) Typical Low $69.18 Median $89.13 Typical High $151.36 | Professional | None (both parts) | $69.18 | $89.13 | $151.36 |
12 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 $34.67 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $34.67 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $14.13 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $10.47 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.92 | $8.32 | $8.32 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $33.88 Median $41.69 Typical High $51.29 | Professional | 26 · Professional part | $33.88 | $41.69 | $51.29 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $128.82 Median $158.49 Typical High $194.98 | Professional | 50 · Both sides | $128.82 | $158.49 | $194.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $42.66 Median $52.48 Typical High $64.57 | Professional | 51 · Multiple procedures | $42.66 | $52.48 | $64.57 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.98 Median $20.89 Typical High $25.70 | Professional | 80 · Assistant surgeon | $16.98 | $20.89 | $25.70 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.02 Median $14.79 Typical High $18.20 | Professional | 81 · Minimal assistant surgeon | $12.02 | $14.79 | $18.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.02 Median $14.79 Typical High $18.20 | Professional | 82 · Assistant surgeon, no resident | $12.02 | $14.79 | $18.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.02 Median $14.79 Typical High $18.20 | Professional | AS · PA/NP assist | $12.02 | $14.79 | $18.20 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $51.29 Median $63.10 Typical High $77.62 | Professional | TC · Technical part | $51.29 | $63.10 | $77.62 |
Where South Carolina sits
The same service costs 4.5 times more in Wisconsin 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· 19th of 51
$117
WI $288KY $64.57
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.