How much rates vary
Facilitymedian $72 · 10th to 90th $49 to $102Professionalmedian $58 · 10th to 90th $49 to $102
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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None (both parts) Typical Low $48.98 Median $48.98 Typical High $60.26 | Professional | None (both parts) | $48.98 | $48.98 | $60.26 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None (both parts) | $102.33 | $102.33 | $102.33 |
BCBS South Carolina Setting Facility Modifier None Typical Low $91.20 Median $102.33 Typical High $102.33 | Facility | None | $91.20 | $102.33 | $102.33 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $57.54 Median $83.18 Typical High $102.33 | Professional | None (both parts) | $57.54 | $83.18 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None (both parts) Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | None (both parts) | $53.70 | $53.70 | $72.44 |
Medcost Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $70.79 | Professional | None | $48.98 | $48.98 | $70.79 |
Medcost Setting Facility Modifier None Typical Low $31.62 Median $54.95 Typical High $123.03 | Facility | None | $31.62 | $54.95 | $123.03 |
Medcost Setting Professional Modifier None (both parts) Typical Low $56.23 Median $72.44 Typical High $131.83 | Professional | None (both parts) | $56.23 | $72.44 | $131.83 |
Molina Setting Professional Modifier None (both parts) Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None (both parts) | $67.61 | $67.61 | $67.61 |
United Setting Facility Modifier None Typical Low $47.86 Median $64.57 Typical High $131.83 | Facility | None | $47.86 | $64.57 | $131.83 |
United Setting Professional Modifier None (both parts) Typical Low $37.15 Median $48.98 Typical High $61.66 | Professional | None (both parts) | $37.15 | $48.98 | $61.66 |
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 $24.55 Median $24.55 Typical High $29.51 | Professional | 52 · Reduced service | $24.55 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $12.02 | Professional | 53 · Discontinued | $9.77 | $9.77 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $8.91 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $6.03 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $28.84 Median $29.51 Typical High $70.79 | Professional | 26 · Professional part | $28.84 | $29.51 | $70.79 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $83.18 Median $107.15 Typical High $263.03 | Professional | 50 · Both sides | $83.18 | $107.15 | $263.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $28.18 Median $36.31 Typical High $87.10 | Professional | 51 · Multiple procedures | $28.18 | $36.31 | $87.10 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.22 Median $14.45 Typical High $35.48 | Professional | 80 · Assistant surgeon | $11.22 | $14.45 | $35.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.76 Median $10.00 Typical High $24.55 | Professional | 81 · Minimal assistant surgeon | $7.76 | $10.00 | $24.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.76 Median $10.00 Typical High $24.55 | Professional | 82 · Assistant surgeon, no resident | $7.76 | $10.00 | $24.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.76 Median $10.00 Typical High $24.55 | Professional | AS · PA/NP assist | $7.76 | $10.00 | $24.55 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $43.65 Median $44.67 Typical High $104.71 | Professional | TC · Technical part | $43.65 | $44.67 | $104.71 |
Where South Carolina sits
The same service costs 3.2 times more in Hawaii 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· 42nd of 51
$57.54
HI $166FL $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.