How much rates vary
Facilitymedian $89 · 10th to 90th $72 to $148Professionalmedian $85 · 10th to 90th $65 to $148
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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None (both parts) Typical Low $66.07 Median $72.44 Typical High $128.82 | Professional | None (both parts) | $66.07 | $72.44 | $128.82 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None (both parts) | $125.89 | $125.89 | $125.89 |
BCBS South Carolina Setting Facility Modifier None Typical Low $134.90 Median $147.91 Typical High $147.91 | Facility | None | $134.90 | $147.91 | $147.91 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $85.11 Median $125.89 Typical High $147.91 | Professional | None (both parts) | $85.11 | $125.89 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $89.13 Typical High $89.13 | Facility | None | $85.11 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None (both parts) Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None (both parts) | $64.57 | $64.57 | $89.13 |
Medcost Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | None | $60.26 | $60.26 | $66.07 |
Medcost Setting Facility Modifier None Typical Low $35.48 Median $75.86 Typical High $181.97 | Facility | None | $35.48 | $75.86 | $181.97 |
Medcost Setting Professional Modifier None (both parts) Typical Low $81.28 Median $107.15 Typical High $194.98 | Professional | None (both parts) | $81.28 | $107.15 | $194.98 |
Molina Setting Professional Modifier None (both parts) Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None (both parts) | $100.00 | $100.00 | $100.00 |
United Setting Facility Modifier None Typical Low $72.44 Median $75.86 Typical High $151.36 | Facility | None | $72.44 | $75.86 | $151.36 |
United Setting Professional Modifier None (both parts) Typical Low $45.71 Median $69.18 Typical High $89.13 | Professional | None (both parts) | $45.71 | $69.18 | $89.13 |
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 $36.31 Median $36.31 Typical High $43.65 | Professional | 52 · Reduced service | $36.31 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $17.78 | Professional | 53 · Discontinued | $14.45 | $14.45 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $13.18 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $8.71 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $42.66 Median $43.65 Typical High $104.71 | Professional | 26 · Professional part | $42.66 | $43.65 | $104.71 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $158.49 Typical High $389.05 | Professional | 50 · Both sides | $123.03 | $158.49 | $389.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $40.74 Median $52.48 Typical High $128.82 | Professional | 51 · Multiple procedures | $40.74 | $52.48 | $128.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.22 Median $21.38 Typical High $52.48 | Professional | 80 · Assistant surgeon | $16.22 | $21.38 | $52.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.48 Median $14.79 Typical High $36.31 | Professional | 81 · Minimal assistant surgeon | $11.48 | $14.79 | $36.31 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.48 Median $14.79 Typical High $36.31 | Professional | 82 · Assistant surgeon, no resident | $11.48 | $14.79 | $36.31 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $11.48 Median $14.79 Typical High $36.31 | Professional | AS · PA/NP assist | $11.48 | $14.79 | $36.31 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $63.10 Median $66.07 Typical High $154.88 | Professional | TC · Technical part | $63.10 | $66.07 | $154.88 |
Where South Carolina sits
The same service costs 2.8 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· 23rd of 51
$85.11
HI $166DC $58.88
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.