How much rates vary
Facilitymedian $76 · 10th to 90th $55 to $115Professionalmedian $65 · 10th to 90th $55 to $115
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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None (both parts) Typical Low $54.95 Median $54.95 Typical High $69.18 | Professional | None (both parts) | $54.95 | $54.95 | $69.18 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $89.13 Median $89.13 Typical High $114.82 | Professional | None (both parts) | $89.13 | $89.13 | $114.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $102.33 Median $114.82 Typical High $114.82 | Facility | None | $102.33 | $114.82 | $114.82 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $64.57 Median $93.33 Typical High $114.82 | Professional | None (both parts) | $64.57 | $93.33 | $114.82 |
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 $75.86 | Professional | None (both parts) | $54.95 | $54.95 | $75.86 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Medcost Setting Facility Modifier None Typical Low $34.67 Median $61.66 Typical High $138.04 | Facility | None | $34.67 | $61.66 | $138.04 |
Medcost Setting Professional Modifier None (both parts) Typical Low $63.10 Median $81.28 Typical High $151.36 | Professional | None (both parts) | $63.10 | $81.28 | $151.36 |
Molina Setting Professional Modifier None (both parts) Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None (both parts) | $75.86 | $75.86 | $75.86 |
United Setting Facility Modifier None Typical Low $69.18 Median $72.44 Typical High $147.91 | Facility | None | $69.18 | $72.44 | $147.91 |
United Setting Professional Modifier None (both parts) Typical Low $41.69 Median $54.95 Typical High $69.18 | Professional | None (both parts) | $41.69 | $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 $27.54 Median $27.54 Typical High $34.67 | Professional | 52 · Reduced service | $27.54 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $13.80 | Professional | 53 · Discontinued | $11.22 | $11.22 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $10.47 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $6.92 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $32.36 Median $33.88 Typical High $79.43 | Professional | 26 · Professional part | $32.36 | $33.88 | $79.43 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $95.50 Median $120.23 Typical High $295.12 | Professional | 50 · Both sides | $95.50 | $120.23 | $295.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $31.62 Median $40.74 Typical High $100.00 | Professional | 51 · Multiple procedures | $31.62 | $40.74 | $100.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.59 Median $16.22 Typical High $39.81 | Professional | 80 · Assistant surgeon | $12.59 | $16.22 | $39.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.91 Median $11.22 Typical High $27.54 | Professional | 81 · Minimal assistant surgeon | $8.91 | $11.22 | $27.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.91 Median $11.22 Typical High $27.54 | Professional | 82 · Assistant surgeon, no resident | $8.91 | $11.22 | $27.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.91 Median $11.22 Typical High $27.54 | Professional | AS · PA/NP assist | $8.91 | $11.22 | $27.54 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $48.98 Median $50.12 Typical High $120.23 | Professional | TC · Technical part | $48.98 | $50.12 | $120.23 |
Where South Carolina sits
The same service costs 3.1 times more in Hawaii than in New Jersey. 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· 41st of 51
$64.57
HI $170NJ $54.95
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.