How much rates vary
Facilitymedian $66 · 10th to 90th $51 to $117Professionalmedian $68 · 10th to 90th $49 to $117
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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $57.54 Median $57.54 Typical High $69.18 | Professional | None (both parts) | $57.54 | $57.54 | $69.18 |
BCBS South Carolina Setting Facility Modifier None Typical Low $104.71 Median $117.49 Typical High $117.49 | Facility | None | $104.71 | $117.49 | $117.49 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $67.61 Median $95.50 Typical High $117.49 | Professional | None (both parts) | $67.61 | $95.50 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None (both parts) Typical Low $48.98 Median $48.98 Typical High $69.18 | Professional | None (both parts) | $48.98 | $48.98 | $69.18 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $56.23 | Professional | None | $50.12 | $50.12 | $56.23 |
Medcost Setting Facility Modifier None Typical Low $28.18 Median $60.26 Typical High $141.25 | Facility | None | $28.18 | $60.26 | $141.25 |
Medcost Setting Professional Modifier None (both parts) Typical Low $64.57 Median $83.18 Typical High $154.88 | Professional | None (both parts) | $64.57 | $83.18 | $154.88 |
Molina Setting Professional Modifier None (both parts) Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None (both parts) | $77.62 | $77.62 | $77.62 |
United Setting Facility Modifier None Typical Low $47.86 Median $58.88 Typical High $120.23 | Facility | None | $47.86 | $58.88 | $120.23 |
United Setting Professional Modifier None (both parts) Typical Low $36.31 Median $54.95 Typical High $69.18 | Professional | None (both parts) | $36.31 | $54.95 | $69.18 |
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 $28.18 Median $28.18 Typical High $34.67 | Professional | 52 · Reduced service | $28.18 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $13.80 | Professional | 53 · Discontinued | $11.48 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $10.23 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $6.92 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $33.11 Median $34.67 Typical High $81.28 | Professional | 26 · Professional part | $33.11 | $34.67 | $81.28 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $97.72 Median $125.89 Typical High $302.00 | Professional | 50 · Both sides | $97.72 | $125.89 | $302.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $32.36 Median $41.69 Typical High $102.33 | Professional | 51 · Multiple procedures | $32.36 | $41.69 | $102.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.88 Median $16.60 Typical High $40.74 | Professional | 80 · Assistant surgeon | $12.88 | $16.60 | $40.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.12 Median $11.75 Typical High $28.18 | Professional | 81 · Minimal assistant surgeon | $9.12 | $11.75 | $28.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.12 Median $11.75 Typical High $28.18 | Professional | 82 · Assistant surgeon, no resident | $9.12 | $11.75 | $28.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.12 Median $11.75 Typical High $28.18 | Professional | AS · PA/NP assist | $9.12 | $11.75 | $28.18 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $50.12 Median $51.29 Typical High $123.03 | Professional | TC · Technical part | $50.12 | $51.29 | $123.03 |
Where South Carolina sits
The same service costs 3.4 times more in Hawaii 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· 20th of 51
$67.61
HI $166VT $48.98
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.