How much rates vary
Facilitymedian $52 · 10th to 90th $34 to $78Professionalmedian $58 · 10th to 90th $34 to $78
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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None (both parts) Typical Low $33.88 Median $33.88 Typical High $47.86 | Professional | None (both parts) | $33.88 | $33.88 | $47.86 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None (both parts) | $85.11 | $85.11 | $85.11 |
BCBS South Carolina Setting Facility Modifier None Typical Low $70.79 Median $77.62 Typical High $77.62 | Facility | None | $70.79 | $77.62 | $77.62 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $57.54 Median $70.79 Typical High $77.62 | Professional | None (both parts) | $57.54 | $70.79 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Cigna Setting Professional Modifier None (both parts) Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | None (both parts) | $44.67 | $44.67 | $52.48 |
Medcost Setting Facility Modifier None Typical Low $19.05 Median $37.15 Typical High $93.33 | Facility | None | $19.05 | $37.15 | $93.33 |
Medcost Setting Professional Modifier None (both parts) Typical Low $74.13 Median $74.13 Typical High $91.20 | Professional | None (both parts) | $74.13 | $74.13 | $91.20 |
Molina Setting Professional Modifier None (both parts) Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None (both parts) | $63.10 | $63.10 | $63.10 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None (both parts) Typical Low $31.62 Median $46.77 Typical High $63.10 | Professional | None (both parts) | $31.62 | $46.77 | $63.10 |
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 $16.98 Median $16.98 Typical High $22.39 | Professional | 52 · Reduced service | $16.98 | $16.98 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $8.91 | Professional | 53 · Discontinued | $6.76 | $6.76 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $6.76 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $4.47 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $29.51 Median $29.51 Typical High $48.98 | Professional | 26 · Professional part | $29.51 | $29.51 | $48.98 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $109.65 Typical High $181.97 | Professional | 50 · Both sides | $109.65 | $109.65 | $181.97 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $37.15 Median $37.15 Typical High $60.26 | Professional | 51 · Multiple procedures | $37.15 | $37.15 | $60.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.79 Median $14.79 Typical High $24.55 | Professional | 80 · Assistant surgeon | $14.79 | $14.79 | $24.55 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.23 Median $10.23 Typical High $16.98 | Professional | 81 · Minimal assistant surgeon | $10.23 | $10.23 | $16.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.23 Median $10.23 Typical High $16.98 | Professional | 82 · Assistant surgeon, no resident | $10.23 | $10.23 | $16.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.23 Median $10.23 Typical High $16.98 | Professional | AS · PA/NP assist | $10.23 | $10.23 | $16.98 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $44.67 Median $44.67 Typical High $72.44 | Professional | TC · Technical part | $44.67 | $44.67 | $72.44 |
Where South Carolina sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 11th of 51
$57.54
HI $93.33UT $36.31
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.