How much rates vary
Facilitymedian $87 · 10th to 90th $63 to $141Professionalmedian $79 · 10th to 90th $63 to $141
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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None (both parts) Typical Low $67.61 Median $67.61 Typical High $85.11 | Professional | None (both parts) | $67.61 | $67.61 | $85.11 |
BCBS South Carolina Setting Facility Modifier None Typical Low $125.89 Median $141.25 Typical High $141.25 | Facility | None | $125.89 | $141.25 | $141.25 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $79.43 Median $114.82 Typical High $141.25 | Professional | None (both parts) | $79.43 | $114.82 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None (both parts) Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None (both parts) | $63.10 | $63.10 | $87.10 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $95.50 | Professional | None | $91.20 | $91.20 | $95.50 |
Medcost Setting Facility Modifier None Typical Low $44.67 Median $81.28 Typical High $169.82 | Facility | None | $44.67 | $81.28 | $169.82 |
Medcost Setting Professional Modifier None (both parts) Typical Low $77.62 Median $100.00 Typical High $181.97 | Professional | None (both parts) | $77.62 | $100.00 | $181.97 |
Molina Setting Professional Modifier None (both parts) Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None (both parts) | $93.33 | $93.33 | $93.33 |
United Setting Facility Modifier None Typical Low $39.81 Median $69.18 Typical High $186.21 | Facility | None | $39.81 | $69.18 | $186.21 |
United Setting Professional Modifier None (both parts) Typical Low $52.48 Median $69.18 Typical High $87.10 | Professional | None (both parts) | $52.48 | $69.18 | $87.10 |
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 $33.88 Median $33.88 Typical High $42.66 | Professional | 52 · Reduced service | $33.88 | $33.88 | $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 $10.23 Median $10.23 Typical High $12.88 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $8.51 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $39.81 Median $41.69 Typical High $97.72 | Professional | 26 · Professional part | $39.81 | $41.69 | $97.72 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $154.88 Typical High $363.08 | Professional | 50 · Both sides | $117.49 | $154.88 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $38.90 Median $51.29 Typical High $123.03 | Professional | 51 · Multiple procedures | $38.90 | $51.29 | $123.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.49 Median $20.42 Typical High $48.98 | Professional | 80 · Assistant surgeon | $15.49 | $20.42 | $48.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.96 Median $14.45 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $10.96 | $14.45 | $33.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.96 Median $14.45 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $10.96 | $14.45 | $33.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.96 Median $14.45 Typical High $33.88 | Professional | AS · PA/NP assist | $10.96 | $14.45 | $33.88 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $58.88 Median $61.66 Typical High $147.91 | Professional | TC · Technical part | $58.88 | $61.66 | $147.91 |
Where South Carolina sits
The same service costs 2.5 times more in Arkansas 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· 43rd of 51
$79.43
AR $158FL $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.