How much rates vary
Facilitymedian $65 · 10th to 90th $51 to $105Professionalmedian $60 · 10th to 90th $47 to $105
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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None (both parts) Typical Low $51.29 Median $51.29 Typical High $63.10 | Professional | None (both parts) | $51.29 | $51.29 | $63.10 |
BCBS South Carolina Setting Facility Modifier None Typical Low $95.50 Median $104.71 Typical High $104.71 | Facility | None | $95.50 | $104.71 | $104.71 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $60.26 Median $87.10 Typical High $104.71 | Professional | None (both parts) | $60.26 | $87.10 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None (both parts) Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None (both parts) | $46.77 | $46.77 | $64.57 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $67.61 | Professional | None | $64.57 | $64.57 | $67.61 |
Medcost Setting Facility Modifier None Typical Low $33.11 Median $61.66 Typical High $125.89 | Facility | None | $33.11 | $61.66 | $125.89 |
Medcost Setting Professional Modifier None (both parts) Typical Low $57.54 Median $74.13 Typical High $138.04 | Professional | None (both parts) | $57.54 | $74.13 | $138.04 |
Molina Setting Professional Modifier None (both parts) Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None (both parts) | $69.18 | $69.18 | $69.18 |
United Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $141.25 | Facility | None | $50.12 | $60.26 | $141.25 |
United Setting Professional Modifier None (both parts) Typical Low $39.81 Median $51.29 Typical High $64.57 | Professional | None (both parts) | $39.81 | $51.29 | $64.57 |
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 $25.70 Median $25.70 Typical High $31.62 | Professional | 52 · Reduced service | $25.70 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $12.59 | Professional | 53 · Discontinued | $10.23 | $10.23 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $9.55 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $6.31 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $29.51 Median $30.90 Typical High $72.44 | Professional | 26 · Professional part | $29.51 | $30.90 | $72.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $87.10 Median $112.20 Typical High $275.42 | Professional | 50 · Both sides | $87.10 | $112.20 | $275.42 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $28.84 Median $37.15 Typical High $91.20 | Professional | 51 · Multiple procedures | $28.84 | $37.15 | $91.20 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.48 Median $14.79 Typical High $36.31 | Professional | 80 · Assistant surgeon | $11.48 | $14.79 | $36.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.13 Median $10.47 Typical High $25.70 | Professional | 81 · Minimal assistant surgeon | $8.13 | $10.47 | $25.70 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.13 Median $10.47 Typical High $25.70 | Professional | 82 · Assistant surgeon, no resident | $8.13 | $10.47 | $25.70 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.13 Median $10.47 Typical High $25.70 | Professional | AS · PA/NP assist | $8.13 | $10.47 | $25.70 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $44.67 Median $46.77 Typical High $109.65 | Professional | TC · Technical part | $44.67 | $46.77 | $109.65 |
Where South Carolina sits
The same service costs 2.8 times more in Wisconsin than in Delaware. 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
$60.26
WI $132DE $46.77
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.