How much rates vary
Facilitymedian $69 · 10th to 90th $52 to $692Professionalmedian $87 · 10th to 90th $59 to $138
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $52.48 Median $58.88 Typical High $69.18 | Facility | None | $52.48 | $58.88 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $158.49 | Professional | None | $52.48 | $69.18 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $131.83 | Professional | None | $61.66 | $91.20 | $131.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $645.65 Median $691.83 Typical High $794.33 | Facility | None | $645.65 | $691.83 | $794.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $104.71 | Professional | None | $81.28 | $81.28 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $147.91 | Professional | None | $81.28 | $97.72 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $181.97 | Professional | None | $117.49 | $117.49 | $181.97 |
Medcost Setting Facility Modifier None Typical Low $63.10 Median $75.86 Typical High $229.09 | Facility | None | $63.10 | $75.86 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $125.89 | Professional | None | $79.43 | $102.33 | $125.89 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $91.20 Typical High $131.83 | Professional | None | $69.18 | $91.20 | $131.83 |
United Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $158.49 | Professional | None | $77.62 | $97.72 | $158.49 |
15 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 $34.67 Typical High $48.98 | Professional | 52 · Reduced service | $34.67 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $9.77 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 24 · Unrelated visit after surgery | $112.20 | $112.20 | $112.20 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $79.43 Median $102.33 Typical High $131.83 | Professional | 25 · Same-day visit | $79.43 | $102.33 | $131.83 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $91.20 Median $104.71 Typical High $134.90 | Professional | 57 · Decision for surgery | $91.20 | $104.71 | $134.90 |
Ambetter Setting Professional Modifier AI · Physician of record Typical Low $72.44 Median $72.44 Typical High $134.90 | Professional | AI · Physician of record | $72.44 | $72.44 | $134.90 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $102.33 Median $102.33 Typical High $134.90 | Professional | FS · Shared visit | $102.33 | $102.33 | $134.90 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $72.44 Median $102.33 Typical High $134.90 | Professional | GC · Resident with teaching physician | $72.44 | $102.33 | $134.90 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $72.44 Median $87.10 Typical High $138.04 | Professional | 29 | $72.44 | $87.10 | $138.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $39.81 Median $51.29 Typical High $74.13 | Professional | 51 · Multiple procedures | $39.81 | $51.29 | $74.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.85 Median $20.42 Typical High $29.51 | Professional | 80 · Assistant surgeon | $15.85 | $20.42 | $29.51 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.22 Median $14.45 Typical High $20.89 | Professional | 81 · Minimal assistant surgeon | $11.22 | $14.45 | $20.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.22 Median $14.45 Typical High $20.89 | Professional | 82 · Assistant surgeon, no resident | $11.22 | $14.45 | $20.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $11.22 Median $14.45 Typical High $20.89 | Professional | AS · PA/NP assist | $11.22 | $14.45 | $20.89 |
Where South Carolina sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 42nd of 51
$87.10
AK $174AL $74.13
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.