How much rates vary
Facilitymedian $81 · 10th to 90th $63 to $132Professionalmedian $76 · 10th to 90th $59 to $132
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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None (both parts) Typical Low $63.10 Median $63.10 Typical High $77.62 | Professional | None (both parts) | $63.10 | $63.10 | $77.62 |
BCBS South Carolina Setting Facility Modifier None Typical Low $117.49 Median $131.83 Typical High $131.83 | Facility | None | $117.49 | $131.83 | $131.83 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $75.86 Median $107.15 Typical High $131.83 | Professional | None (both parts) | $75.86 | $107.15 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None (both parts) Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None (both parts) | $58.88 | $58.88 | $81.28 |
Medcost Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $91.20 | Professional | None | $81.28 | $81.28 | $91.20 |
Medcost Setting Facility Modifier None Typical Low $41.69 Median $72.44 Typical High $158.49 | Facility | None | $41.69 | $72.44 | $158.49 |
Medcost Setting Professional Modifier None (both parts) Typical Low $72.44 Median $93.33 Typical High $169.82 | Professional | None (both parts) | $72.44 | $93.33 | $169.82 |
Molina Setting Professional Modifier None (both parts) Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None (both parts) | $87.10 | $87.10 | $87.10 |
United Setting Facility Modifier None Typical Low $79.43 Median $85.11 Typical High $173.78 | Facility | None | $79.43 | $85.11 | $173.78 |
United Setting Professional Modifier None (both parts) Typical Low $48.98 Median $64.57 Typical High $81.28 | Professional | None (both parts) | $48.98 | $64.57 | $81.28 |
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 $31.62 Median $31.62 Typical High $38.90 | Professional | 52 · Reduced service | $31.62 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $15.49 | Professional | 53 · Discontinued | $12.88 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $11.48 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $7.76 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $37.15 Median $38.90 Typical High $91.20 | Professional | 26 · Professional part | $37.15 | $38.90 | $91.20 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $138.04 Typical High $338.84 | Professional | 50 · Both sides | $107.15 | $138.04 | $338.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $36.31 Median $46.77 Typical High $114.82 | Professional | 51 · Multiple procedures | $36.31 | $46.77 | $114.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.45 Median $18.62 Typical High $45.71 | Professional | 80 · Assistant surgeon | $14.45 | $18.62 | $45.71 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.00 Median $12.88 Typical High $31.62 | Professional | 81 · Minimal assistant surgeon | $10.00 | $12.88 | $31.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.00 Median $12.88 Typical High $31.62 | Professional | 82 · Assistant surgeon, no resident | $10.00 | $12.88 | $31.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.00 Median $12.88 Typical High $31.62 | Professional | AS · PA/NP assist | $10.00 | $12.88 | $31.62 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $56.23 Median $57.54 Typical High $138.04 | Professional | TC · Technical part | $56.23 | $57.54 | $138.04 |
Where South Carolina sits
The same service costs 5.1 times more in Kansas 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
$75.86
KS $309FL $60.26
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.