How much rates vary
Facilitymedian $123 · 10th to 90th $100 to $204Professionalmedian $117 · 10th to 90th $89 to $204
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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None (both parts) Typical Low $100.00 Median $100.00 Typical High $123.03 | Professional | None (both parts) | $100.00 | $100.00 | $123.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $186.21 Median $204.17 Typical High $204.17 | Facility | None | $186.21 | $204.17 | $204.17 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $117.49 Median $169.82 Typical High $204.17 | Professional | None (both parts) | $117.49 | $169.82 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None (both parts) Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None (both parts) | $89.13 | $89.13 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $117.49 | Professional | None | $107.15 | $117.49 | $117.49 |
Medcost Setting Facility Modifier None Typical Low $56.23 Median $109.65 Typical High $245.47 | Facility | None | $56.23 | $109.65 | $245.47 |
Medcost Setting Professional Modifier None (both parts) Typical Low $112.20 Median $144.54 Typical High $269.15 | Professional | None (both parts) | $112.20 | $144.54 | $269.15 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $239.88 | Facility | None | $87.10 | $100.00 | $239.88 |
United Setting Professional Modifier None (both parts) Typical Low $67.61 Median $97.72 Typical High $120.23 | Professional | None (both parts) | $67.61 | $97.72 | $120.23 |
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 $50.12 Median $50.12 Typical High $60.26 | Professional | 52 · Reduced service | $50.12 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $23.99 | Professional | 53 · Discontinued | $19.95 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $12.02 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $57.54 Median $60.26 Typical High $141.25 | Professional | 26 · Professional part | $57.54 | $60.26 | $141.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $213.80 Typical High $537.03 | Professional | 50 · Both sides | $169.82 | $213.80 | $537.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $56.23 Median $72.44 Typical High $177.83 | Professional | 51 · Multiple procedures | $56.23 | $72.44 | $177.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.39 Median $28.84 Typical High $70.79 | Professional | 80 · Assistant surgeon | $22.39 | $28.84 | $70.79 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.85 Median $19.95 Typical High $50.12 | Professional | 81 · Minimal assistant surgeon | $15.85 | $19.95 | $50.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.85 Median $19.95 Typical High $50.12 | Professional | 82 · Assistant surgeon, no resident | $15.85 | $19.95 | $50.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.85 Median $19.95 Typical High $50.12 | Professional | AS · PA/NP assist | $15.85 | $19.95 | $50.12 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $87.10 Median $91.20 Typical High $213.80 | Professional | TC · Technical part | $87.10 | $91.20 | $213.80 |
Where South Carolina sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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
$117
HI $219AZ $89.13
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.