How much rates vary
Facilitymedian $66 · 10th to 90th $50 to $85Professionalmedian $72 · 10th to 90th $56 to $117
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 $50.12 Median $61.66 Typical High $85.11 | Facility | None | $50.12 | $61.66 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $66.07 Typical High $109.65 | Professional | None | $50.12 | $66.07 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $72.44 Typical High $117.49 | Professional | None | $58.88 | $72.44 | $117.49 |
BCBS South Carolina Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $74.13 | Professional | None | $46.77 | $46.77 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $128.82 | Professional | None | $60.26 | $70.79 | $128.82 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $131.83 | Professional | None | $85.11 | $85.11 | $131.83 |
Medcost Setting Facility Modifier None Typical Low $52.48 Median $72.44 Typical High $218.78 | Facility | None | $52.48 | $72.44 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $107.15 | Professional | None | $66.07 | $77.62 | $107.15 |
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 $60.26 Median $72.44 Typical High $123.03 | Professional | None | $60.26 | $72.44 | $123.03 |
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 $31.62 Median $33.11 Typical High $34.67 | Professional | 52 · Reduced service | $31.62 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.00 Typical High $10.47 | Professional | 55 · Aftercare only | $9.33 | $10.00 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.61 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.31 | $6.61 | $6.92 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $60.26 Median $69.18 Typical High $125.89 | Professional | 24 · Unrelated visit after surgery | $60.26 | $69.18 | $125.89 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $58.88 Median $95.50 Typical High $123.03 | Professional | 25 · Same-day visit | $58.88 | $95.50 | $123.03 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 57 · Decision for surgery | $123.03 | $123.03 | $123.03 |
Ambetter Setting Professional Modifier AI · Physician of record Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | AI · Physician of record | $69.18 | $69.18 | $69.18 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $95.50 Median $107.15 Typical High $125.89 | Professional | FS · Shared visit | $95.50 | $107.15 | $125.89 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $69.18 Median $102.33 Typical High $125.89 | Professional | GC · Resident with teaching physician | $69.18 | $102.33 | $125.89 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $46.77 Median $70.79 Typical High $102.33 | Professional | 29 | $46.77 | $70.79 | $102.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.11 Median $38.90 Typical High $67.61 | Professional | 51 · Multiple procedures | $33.11 | $38.90 | $67.61 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.18 Median $15.49 Typical High $26.92 | Professional | 80 · Assistant surgeon | $13.18 | $15.49 | $26.92 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.33 Median $10.96 Typical High $18.62 | Professional | 81 · Minimal assistant surgeon | $9.33 | $10.96 | $18.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.33 Median $10.96 Typical High $18.62 | Professional | 82 · Assistant surgeon, no resident | $9.33 | $10.96 | $18.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.33 Median $10.96 Typical High $18.62 | Professional | AS · PA/NP assist | $9.33 | $10.96 | $18.62 |
Where South Carolina sits
The same service costs 2.4 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· 41st of 51
$72.44
AK $155AL $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.