How much rates vary
Facilitymedian $78 · 10th to 90th $63 to $145Professionalmedian $81 · 10th to 90th $62 to $145
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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None (both parts) Typical Low $69.18 Median $69.18 Typical High $85.11 | Professional | None (both parts) | $69.18 | $69.18 | $85.11 |
BCBS South Carolina Setting Facility Modifier None Typical Low $19.95 Median $128.82 Typical High $144.54 | Facility | None | $19.95 | $128.82 | $144.54 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $81.28 Median $117.49 Typical High $144.54 | Professional | None (both parts) | $81.28 | $117.49 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $100.00 | Facility | None | $77.62 | $77.62 | $100.00 |
Cigna Setting Professional Modifier None (both parts) Typical Low $56.23 Median $56.23 Typical High $89.13 | Professional | None (both parts) | $56.23 | $56.23 | $89.13 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $81.28 | Professional | None | $61.66 | $61.66 | $81.28 |
Medcost Setting Facility Modifier None Typical Low $38.90 Median $83.18 Typical High $173.78 | Facility | None | $38.90 | $83.18 | $173.78 |
Medcost Setting Professional Modifier None (both parts) Typical Low $79.43 Median $102.33 Typical High $186.21 | Professional | None (both parts) | $79.43 | $102.33 | $186.21 |
Molina Setting Professional Modifier None (both parts) Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None (both parts) | $61.66 | $61.66 | $61.66 |
United Setting Facility Modifier None Typical Low $60.26 Median $81.28 Typical High $165.96 | Facility | None | $60.26 | $81.28 | $165.96 |
United Setting Professional Modifier None (both parts) Typical Low $46.77 Median $69.18 Typical High $85.11 | Professional | None (both parts) | $46.77 | $69.18 | $85.11 |
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 $34.67 Median $34.67 Typical High $42.66 | Professional | 52 · Reduced service | $34.67 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $16.98 | Professional | 53 · Discontinued | $13.80 | $13.80 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $12.59 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $8.51 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $40.74 Median $42.66 Typical High $100.00 | Professional | 26 · Professional part | $40.74 | $42.66 | $100.00 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $151.36 Typical High $371.54 | Professional | 50 · Both sides | $117.49 | $151.36 | $371.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $39.81 Median $51.29 Typical High $125.89 | Professional | 51 · Multiple procedures | $39.81 | $51.29 | $125.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.85 Median $20.42 Typical High $50.12 | Professional | 80 · Assistant surgeon | $15.85 | $20.42 | $50.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.96 Median $14.13 Typical High $34.67 | Professional | 81 · Minimal assistant surgeon | $10.96 | $14.13 | $34.67 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.96 Median $14.13 Typical High $34.67 | Professional | 82 · Assistant surgeon, no resident | $10.96 | $14.13 | $34.67 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.96 Median $14.13 Typical High $34.67 | Professional | AS · PA/NP assist | $10.96 | $14.13 | $34.67 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $61.66 Median $63.10 Typical High $151.36 | Professional | TC · Technical part | $61.66 | $63.10 | $151.36 |
Where South Carolina sits
The same service costs 3.1 times more in Hawaii 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· 26th of 51
$81.28
HI $174DE $56.23
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.