How much rates vary
Facilitymedian $83 · 10th to 90th $59 to $129Professionalmedian $72 · 10th to 90th $58 to $129
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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None (both parts) Typical Low $61.66 Median $61.66 Typical High $75.86 | Professional | None (both parts) | $61.66 | $61.66 | $75.86 |
BCBS South Carolina Setting Facility Modifier None Typical Low $29.51 Median $128.82 Typical High $128.82 | Facility | None | $29.51 | $128.82 | $128.82 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $72.44 Median $104.71 Typical High $128.82 | Professional | None (both parts) | $72.44 | $104.71 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None (both parts) Typical Low $61.66 Median $61.66 Typical High $83.18 | Professional | None (both parts) | $61.66 | $61.66 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $61.66 Typical High $61.66 | Professional | None | $58.88 | $61.66 | $61.66 |
Medcost Setting Facility Modifier None Typical Low $31.62 Median $66.07 Typical High $154.88 | Facility | None | $31.62 | $66.07 | $154.88 |
Medcost Setting Professional Modifier None (both parts) Typical Low $70.79 Median $91.20 Typical High $165.96 | Professional | None (both parts) | $70.79 | $91.20 | $165.96 |
Molina 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 |
United Setting Facility Modifier None Typical Low $64.57 Median $72.44 Typical High $131.83 | Facility | None | $64.57 | $72.44 | $131.83 |
United Setting Professional Modifier None (both parts) Typical Low $40.74 Median $60.26 Typical High $75.86 | Professional | None (both parts) | $40.74 | $60.26 | $75.86 |
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 $30.90 Median $30.90 Typical High $38.02 | Professional | 52 · Reduced service | $30.90 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $15.14 | Professional | 53 · Discontinued | $12.59 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $11.22 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $7.59 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $36.31 Median $38.02 Typical High $89.13 | Professional | 26 · Professional part | $36.31 | $38.02 | $89.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $138.04 Typical High $331.13 | Professional | 50 · Both sides | $107.15 | $138.04 | $331.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $35.48 Median $45.71 Typical High $112.20 | Professional | 51 · Multiple procedures | $35.48 | $45.71 | $112.20 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.13 Median $18.20 Typical High $44.67 | Professional | 80 · Assistant surgeon | $14.13 | $18.20 | $44.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.00 Median $12.88 Typical High $30.90 | Professional | 81 · Minimal assistant surgeon | $10.00 | $12.88 | $30.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.00 Median $12.88 Typical High $30.90 | Professional | 82 · Assistant surgeon, no resident | $10.00 | $12.88 | $30.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.00 Median $12.88 Typical High $30.90 | Professional | AS · PA/NP assist | $10.00 | $12.88 | $30.90 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $54.95 Median $56.23 Typical High $134.90 | Professional | TC · Technical part | $54.95 | $56.23 | $134.90 |
Where South Carolina sits
The same service costs 3.5 times more in Hawaii than in Washington, DC. 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· 20th of 51
$72.44
HI $186DC $52.48
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.