How much rates vary
Facilitymedian $22 · 10th to 90th $17 to $42Professionalmedian $20 · 10th to 90th $16 to $35
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 $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier None (both parts) Typical Low $16.60 Median $16.60 Typical High $25.70 | Professional | None (both parts) | $16.60 | $16.60 | $25.70 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $22.39 Median $28.18 Typical High $34.67 | Professional | None (both parts) | $22.39 | $28.18 | $34.67 |
BCBS South Carolina Setting Facility Modifier None Typical Low $15.85 Median $34.67 Typical High $77.62 | Facility | None | $15.85 | $34.67 | $77.62 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $19.95 Median $21.38 Typical High $34.67 | Professional | None (both parts) | $19.95 | $21.38 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $31.62 | Facility | None | $22.39 | $22.39 | $31.62 |
Cigna Setting Professional Modifier None (both parts) Typical Low $16.22 Median $16.22 Typical High $24.55 | Professional | None (both parts) | $16.22 | $16.22 | $24.55 |
Medcost Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $19.05 | Professional | None | $15.14 | $15.14 | $19.05 |
Medcost Setting Facility Modifier None Typical Low $9.55 Median $19.95 Typical High $41.69 | Facility | None | $9.55 | $19.95 | $41.69 |
Medcost Setting Professional Modifier None (both parts) Typical Low $19.05 Median $25.12 Typical High $44.67 | Professional | None (both parts) | $19.05 | $25.12 | $44.67 |
Molina Setting Professional Modifier None (both parts) Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None (both parts) | $22.91 | $22.91 | $22.91 |
United Setting Facility Modifier None Typical Low $19.95 Median $28.18 Typical High $40.74 | Facility | None | $19.95 | $28.18 | $40.74 |
United Setting Professional Modifier None (both parts) Typical Low $11.48 Median $16.60 Typical High $20.42 | Professional | None (both parts) | $11.48 | $16.60 | $20.42 |
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 $8.32 Median $8.32 Typical High $10.23 | Professional | 52 · Reduced service | $8.32 | $8.32 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.39 Typical High $4.07 | Professional | 53 · Discontinued | $3.39 | $3.39 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $3.02 | Professional | 55 · Aftercare only | $2.51 | $2.51 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.70 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.70 | $1.70 | $2.04 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $10.00 Median $10.23 Typical High $23.99 | Professional | 26 · Professional part | $10.00 | $10.23 | $23.99 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $28.18 Median $37.15 Typical High $89.13 | Professional | 50 · Both sides | $28.18 | $37.15 | $89.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $9.55 Median $12.59 Typical High $30.20 | Professional | 51 · Multiple procedures | $9.55 | $12.59 | $30.20 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.80 Median $5.01 Typical High $12.02 | Professional | 80 · Assistant surgeon | $3.80 | $5.01 | $12.02 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.63 Median $3.47 Typical High $8.32 | Professional | 81 · Minimal assistant surgeon | $2.63 | $3.47 | $8.32 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.63 Median $3.47 Typical High $8.32 | Professional | 82 · Assistant surgeon, no resident | $2.63 | $3.47 | $8.32 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.63 Median $3.47 Typical High $8.32 | Professional | AS · PA/NP assist | $2.63 | $3.47 | $8.32 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $15.14 Median $15.14 Typical High $36.31 | Professional | TC · Technical part | $15.14 | $15.14 | $36.31 |
Where South Carolina sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 23rd of 51
$21.38
HI $60.26FL $16.22
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.