How much rates vary
Facilitymedian $39 · 10th to 90th $26 to $55Professionalmedian $31 · 10th to 90th $26 to $55
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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None (both parts) Typical Low $26.30 Median $26.30 Typical High $33.11 | Professional | None (both parts) | $26.30 | $26.30 | $33.11 |
BCBS South Carolina Setting Facility Modifier None Typical Low $48.98 Median $54.95 Typical High $54.95 | Facility | None | $48.98 | $54.95 | $54.95 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $30.90 Median $44.67 Typical High $54.95 | Professional | None (both parts) | $30.90 | $44.67 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None (both parts) Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | None (both parts) | $28.84 | $28.84 | $38.90 |
Medcost Setting Professional Modifier None Typical Low $32.36 Median $35.48 Typical High $35.48 | Professional | None | $32.36 | $35.48 | $35.48 |
Medcost Setting Facility Modifier None Typical Low $17.38 Median $30.20 Typical High $66.07 | Facility | None | $17.38 | $30.20 | $66.07 |
Medcost Setting Professional Modifier None (both parts) Typical Low $30.20 Median $38.90 Typical High $70.79 | Professional | None (both parts) | $30.20 | $38.90 | $70.79 |
Molina Setting Professional Modifier None (both parts) Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None (both parts) | $36.31 | $36.31 | $36.31 |
United Setting Facility Modifier None Typical Low $35.48 Median $51.29 Typical High $72.44 | Facility | None | $35.48 | $51.29 | $72.44 |
United Setting Professional Modifier None (both parts) Typical Low $20.42 Median $26.92 Typical High $33.88 | Professional | None (both parts) | $20.42 | $26.92 | $33.88 |
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 $13.18 Median $13.18 Typical High $16.60 | Professional | 52 · Reduced service | $13.18 | $13.18 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $6.61 | Professional | 53 · Discontinued | $5.25 | $5.25 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $4.90 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $3.31 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $15.49 Median $16.22 Typical High $38.02 | Professional | 26 · Professional part | $15.49 | $16.22 | $38.02 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $44.67 Median $58.88 Typical High $141.25 | Professional | 50 · Both sides | $44.67 | $58.88 | $141.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.14 Median $19.50 Typical High $47.86 | Professional | 51 · Multiple procedures | $15.14 | $19.50 | $47.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.03 Median $7.76 Typical High $19.05 | Professional | 80 · Assistant surgeon | $6.03 | $7.76 | $19.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.17 Median $5.50 Typical High $13.18 | Professional | 81 · Minimal assistant surgeon | $4.17 | $5.50 | $13.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.17 Median $5.50 Typical High $13.18 | Professional | 82 · Assistant surgeon, no resident | $4.17 | $5.50 | $13.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.17 Median $5.50 Typical High $13.18 | Professional | AS · PA/NP assist | $4.17 | $5.50 | $13.18 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $23.44 Median $23.99 Typical High $57.54 | Professional | TC · Technical part | $23.44 | $23.99 | $57.54 |
Where South Carolina sits
The same service costs 4.7 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
$30.90
HI $132FL $28.18
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.