How much rates vary
Facilitymedian $35 · 10th to 90th $31 to $50Professionalmedian $42 · 10th to 90th $34 to $76
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 $30.90 Median $35.48 Typical High $41.69 | Facility | None | $30.90 | $35.48 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $41.69 Typical High $89.13 | Professional | None | $30.90 | $41.69 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $36.31 Median $47.86 Typical High $72.44 | Professional | None | $36.31 | $47.86 | $72.44 |
BCBS South Carolina Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $40.74 | Professional | None | $34.67 | $34.67 | $40.74 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $34.67 Median $38.90 Typical High $60.26 | Professional | 29 | $34.67 | $38.90 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $38.90 Typical High $81.28 | Professional | None | $33.88 | $38.90 | $81.28 |
Medcost Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $70.79 | Professional | None | $43.65 | $43.65 | $70.79 |
Medcost Setting Facility Modifier None Typical Low $31.62 Median $45.71 Typical High $134.90 | Facility | None | $31.62 | $45.71 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $39.81 Median $46.77 Typical High $67.61 | Professional | None | $39.81 | $46.77 | $67.61 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $44.67 Typical High $66.07 | Professional | None | $34.67 | $44.67 | $66.07 |
United Setting Professional Modifier None Typical Low $33.88 Median $39.81 Typical High $69.18 | Professional | None | $33.88 | $39.81 | $69.18 |
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 $18.62 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $18.62 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $5.62 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.72 | $4.17 | $4.17 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $72.44 Median $72.44 Typical High $77.62 | Professional | 24 · Unrelated visit after surgery | $72.44 | $72.44 | $77.62 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $40.74 Median $42.66 Typical High $42.66 | Professional | 25 · Same-day visit | $40.74 | $42.66 | $42.66 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $67.61 Median $67.61 Typical High $79.43 | Professional | FS · Shared visit | $67.61 | $67.61 | $79.43 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $42.66 Median $77.62 Typical High $79.43 | Professional | GC · Resident with teaching physician | $42.66 | $77.62 | $79.43 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.95 Median $23.44 Typical High $40.74 | Professional | 51 · Multiple procedures | $19.95 | $23.44 | $40.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.94 Median $9.33 Typical High $16.22 | Professional | 80 · Assistant surgeon | $7.94 | $9.33 | $16.22 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.62 Median $6.61 Typical High $11.48 | Professional | 81 · Minimal assistant surgeon | $5.62 | $6.61 | $11.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.62 Median $6.61 Typical High $11.48 | Professional | 82 · Assistant surgeon, no resident | $5.62 | $6.61 | $11.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.62 Median $6.61 Typical High $11.48 | Professional | AS · PA/NP assist | $5.62 | $6.61 | $11.48 |
Where South Carolina sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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· 48th of 51
$41.69
AK $100NJ $37.15
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.