How much rates vary
Facilitymedian $76 · 10th to 90th $65 to $158Professionalmedian $78 · 10th to 90th $59 to $135
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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None (both parts) Typical Low $64.57 Median $64.57 Typical High $79.43 | Professional | None (both parts) | $64.57 | $64.57 | $79.43 |
BCBS South Carolina Setting Facility Modifier None Typical Low $120.23 Median $134.90 Typical High $134.90 | Facility | None | $120.23 | $134.90 | $134.90 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $77.62 Median $109.65 Typical High $134.90 | Professional | None (both parts) | $77.62 | $109.65 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None (both parts) Typical Low $54.95 Median $54.95 Typical High $79.43 | Professional | None (both parts) | $54.95 | $54.95 | $79.43 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $81.28 | Professional | None | $75.86 | $75.86 | $81.28 |
Medcost Setting Facility Modifier None Typical Low $37.15 Median $70.79 Typical High $162.18 | Facility | None | $37.15 | $70.79 | $162.18 |
Medcost Setting Professional Modifier None (both parts) Typical Low $74.13 Median $95.50 Typical High $173.78 | Professional | None (both parts) | $74.13 | $95.50 | $173.78 |
Molina Setting Professional Modifier None (both parts) Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None (both parts) | $89.13 | $89.13 | $89.13 |
United Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $158.49 | Facility | None | $77.62 | $87.10 | $158.49 |
United Setting Professional Modifier None (both parts) Typical Low $44.67 Median $64.57 Typical High $79.43 | Professional | None (both parts) | $44.67 | $64.57 | $79.43 |
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 $32.36 Median $32.36 Typical High $39.81 | Professional | 52 · Reduced service | $32.36 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $15.85 | Professional | 53 · Discontinued | $12.88 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $11.75 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $7.94 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $38.02 Median $39.81 Typical High $93.33 | Professional | 26 · Professional part | $38.02 | $39.81 | $93.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $141.25 Typical High $346.74 | Professional | 50 · Both sides | $112.20 | $141.25 | $346.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $37.15 Median $47.86 Typical High $117.49 | Professional | 51 · Multiple procedures | $37.15 | $47.86 | $117.49 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.79 Median $19.05 Typical High $46.77 | Professional | 80 · Assistant surgeon | $14.79 | $19.05 | $46.77 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.47 Median $13.18 Typical High $32.36 | Professional | 81 · Minimal assistant surgeon | $10.47 | $13.18 | $32.36 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.47 Median $13.18 Typical High $32.36 | Professional | 82 · Assistant surgeon, no resident | $10.47 | $13.18 | $32.36 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.47 Median $13.18 Typical High $32.36 | Professional | AS · PA/NP assist | $10.47 | $13.18 | $32.36 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $57.54 Median $58.88 Typical High $141.25 | Professional | TC · Technical part | $57.54 | $58.88 | $141.25 |
Where South Carolina sits
The same service costs 4.4 times more in Kansas than in Vermont. 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· 22nd of 51
$77.62
KS $245VT $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.