How much rates vary
Facilitymedian $120 · 10th to 90th $85 to $209Professionalmedian $120 · 10th to 90th $87 to $209
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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None (both parts) Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | None (both parts) | $102.33 | $102.33 | $123.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $190.55 Median $208.93 Typical High $208.93 | Facility | None | $190.55 | $208.93 | $208.93 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $120.23 Median $173.78 Typical High $208.93 | Professional | None (both parts) | $120.23 | $173.78 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None (both parts) Typical Low $87.10 Median $87.10 Typical High $123.03 | Professional | None (both parts) | $87.10 | $87.10 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $128.82 | Professional | None | $85.11 | $85.11 | $128.82 |
Medcost Setting Facility Modifier None Typical Low $54.95 Median $107.15 Typical High $257.04 | Facility | None | $54.95 | $107.15 | $257.04 |
Medcost Setting Professional Modifier None (both parts) Typical Low $114.82 Median $147.91 Typical High $275.42 | Professional | None (both parts) | $114.82 | $147.91 | $275.42 |
Molina Setting Professional Modifier None (both parts) Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None (both parts) | $138.04 | $138.04 | $138.04 |
United Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $229.09 | Facility | None | $72.44 | $85.11 | $229.09 |
United Setting Professional Modifier None (both parts) Typical Low $69.18 Median $97.72 Typical High $123.03 | Professional | None (both parts) | $69.18 | $97.72 | $123.03 |
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 $51.29 Median $51.29 Typical High $61.66 | Professional | 52 · Reduced service | $51.29 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $24.55 | Professional | 53 · Discontinued | $20.42 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $12.30 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $58.88 Median $61.66 Typical High $144.54 | Professional | 26 · Professional part | $58.88 | $61.66 | $144.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $223.87 Typical High $549.54 | Professional | 50 · Both sides | $173.78 | $223.87 | $549.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $74.13 Typical High $181.97 | Professional | 51 · Multiple procedures | $57.54 | $74.13 | $181.97 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $23.44 Median $29.51 Typical High $72.44 | Professional | 80 · Assistant surgeon | $23.44 | $29.51 | $72.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.22 Median $20.89 Typical High $51.29 | Professional | 81 · Minimal assistant surgeon | $16.22 | $20.89 | $51.29 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.22 Median $20.89 Typical High $51.29 | Professional | 82 · Assistant surgeon, no resident | $16.22 | $20.89 | $51.29 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.22 Median $20.89 Typical High $51.29 | Professional | AS · PA/NP assist | $16.22 | $20.89 | $51.29 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $89.13 Median $93.33 Typical High $218.78 | Professional | TC · Technical part | $89.13 | $93.33 | $218.78 |
Where South Carolina sits
The same service costs 2.4 times more in Montana than in Vermont. 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· 19th of 51
$120
MT $209VT $87.10
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.