How much rates vary
Facilitymedian $91 · 10th to 90th $69 to $191Professionalmedian $110 · 10th to 90th $72 to $191
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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None (both parts) Typical Low $91.20 Median $91.20 Typical High $112.20 | Professional | None (both parts) | $91.20 | $91.20 | $112.20 |
BCBS South Carolina Setting Facility Modifier None Typical Low $169.82 Median $190.55 Typical High $190.55 | Facility | None | $169.82 | $190.55 | $190.55 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $109.65 Median $158.49 Typical High $190.55 | Professional | None (both parts) | $109.65 | $158.49 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None (both parts) Typical Low $66.07 Median $66.07 Typical High $112.20 | Professional | None (both parts) | $66.07 | $66.07 | $112.20 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | None | $83.18 | $83.18 | $91.20 |
Medcost Setting Facility Modifier None Typical Low $44.67 Median $97.72 Typical High $229.09 | Facility | None | $44.67 | $97.72 | $229.09 |
Medcost Setting Professional Modifier None (both parts) Typical Low $104.71 Median $134.90 Typical High $245.47 | Professional | None (both parts) | $104.71 | $134.90 | $245.47 |
Molina 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 |
United Setting Facility Modifier None Typical Low $39.81 Median $69.18 Typical High $190.55 | Facility | None | $39.81 | $69.18 | $190.55 |
United Setting Professional Modifier None (both parts) Typical Low $57.54 Median $89.13 Typical High $112.20 | Professional | None (both parts) | $57.54 | $89.13 | $112.20 |
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 $45.71 Median $45.71 Typical High $56.23 | Professional | 52 · Reduced service | $45.71 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $22.39 | Professional | 53 · Discontinued | $18.62 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $16.60 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $11.22 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $53.70 Median $56.23 Typical High $131.83 | Professional | 26 · Professional part | $53.70 | $56.23 | $131.83 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $158.49 Median $199.53 Typical High $489.78 | Professional | 50 · Both sides | $158.49 | $199.53 | $489.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $52.48 Median $67.61 Typical High $165.96 | Professional | 51 · Multiple procedures | $52.48 | $67.61 | $165.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $20.89 Median $26.92 Typical High $66.07 | Professional | 80 · Assistant surgeon | $20.89 | $26.92 | $66.07 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $14.79 Median $18.62 Typical High $45.71 | Professional | 81 · Minimal assistant surgeon | $14.79 | $18.62 | $45.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $14.79 Median $18.62 Typical High $45.71 | Professional | 82 · Assistant surgeon, no resident | $14.79 | $18.62 | $45.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $14.79 Median $18.62 Typical High $45.71 | Professional | AS · PA/NP assist | $14.79 | $18.62 | $45.71 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $81.28 Median $83.18 Typical High $199.53 | Professional | TC · Technical part | $81.28 | $83.18 | $199.53 |
Where South Carolina sits
The same service costs 2.5 times more in Montana 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· 16th of 51
$110
MT $162DE $66.07
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.