How much rates vary
Facilitymedian $47 · 10th to 90th $36 to $87Professionalmedian $49 · 10th to 90th $36 to $87
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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None (both parts) Typical Low $41.69 Median $41.69 Typical High $52.48 | Professional | None (both parts) | $41.69 | $41.69 | $52.48 |
BCBS South Carolina Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $87.10 | Facility | None | $77.62 | $87.10 | $87.10 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $48.98 Median $70.79 Typical High $87.10 | Professional | None (both parts) | $48.98 | $70.79 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None (both parts) Typical Low $33.88 Median $33.88 Typical High $51.29 | Professional | None (both parts) | $33.88 | $33.88 | $51.29 |
Medcost Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $44.67 | Professional | None | $37.15 | $37.15 | $44.67 |
Medcost Setting Facility Modifier None Typical Low $23.44 Median $50.12 Typical High $104.71 | Facility | None | $23.44 | $50.12 | $104.71 |
Medcost Setting Professional Modifier None (both parts) Typical Low $47.86 Median $61.66 Typical High $112.20 | Professional | None (both parts) | $47.86 | $61.66 | $112.20 |
Molina Setting Professional Modifier None (both parts) Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None (both parts) | $57.54 | $57.54 | $57.54 |
United Setting Facility Modifier None Typical Low $19.05 Median $36.31 Typical High $97.72 | Facility | None | $19.05 | $36.31 | $97.72 |
United Setting Professional Modifier None (both parts) Typical Low $28.18 Median $41.69 Typical High $51.29 | Professional | None (both parts) | $28.18 | $41.69 | $51.29 |
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 $20.89 Median $20.89 Typical High $25.12 | Professional | 52 · Reduced service | $20.89 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $10.23 | Professional | 53 · Discontinued | $8.32 | $8.32 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $7.59 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $5.13 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $24.55 Median $25.70 Typical High $60.26 | Professional | 26 · Professional part | $24.55 | $25.70 | $60.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $72.44 Median $91.20 Typical High $223.87 | Professional | 50 · Both sides | $72.44 | $91.20 | $223.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $23.99 Median $30.20 Typical High $74.13 | Professional | 51 · Multiple procedures | $23.99 | $30.20 | $74.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.55 Median $12.30 Typical High $30.20 | Professional | 80 · Assistant surgeon | $9.55 | $12.30 | $30.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.76 Median $8.51 Typical High $20.89 | Professional | 81 · Minimal assistant surgeon | $6.76 | $8.51 | $20.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.76 Median $8.51 Typical High $20.89 | Professional | 82 · Assistant surgeon, no resident | $6.76 | $8.51 | $20.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.76 Median $8.51 Typical High $20.89 | Professional | AS · PA/NP assist | $6.76 | $8.51 | $20.89 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $36.31 Median $38.02 Typical High $89.13 | Professional | TC · Technical part | $36.31 | $38.02 | $89.13 |
Where South Carolina sits
The same service costs 2.9 times more in Kansas than in Delaware. 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· 25th of 51
$48.98
KS $97.72DE $33.88
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.