How much rates vary
Facilitymedian $49 · 10th to 90th $43 to $89Professionalmedian $50 · 10th to 90th $38 to $89
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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None (both parts) Typical Low $42.66 Median $42.66 Typical High $54.95 | Professional | None (both parts) | $42.66 | $42.66 | $54.95 |
BCBS South Carolina Setting Facility Modifier None Typical Low $79.43 Median $89.13 Typical High $89.13 | Facility | None | $79.43 | $89.13 | $89.13 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $50.12 Median $72.44 Typical High $89.13 | Professional | None (both parts) | $50.12 | $72.44 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None (both parts) Typical Low $35.48 Median $35.48 Typical High $52.48 | Professional | None (both parts) | $35.48 | $35.48 | $52.48 |
Medcost Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $46.77 | Professional | None | $38.02 | $38.02 | $46.77 |
Medcost Setting Facility Modifier None Typical Low $24.55 Median $45.71 Typical High $107.15 | Facility | None | $24.55 | $45.71 | $107.15 |
Medcost Setting Professional Modifier None (both parts) Typical Low $48.98 Median $63.10 Typical High $114.82 | Professional | None (both parts) | $48.98 | $63.10 | $114.82 |
Molina Setting Professional Modifier None (both parts) Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None (both parts) | $58.88 | $58.88 | $58.88 |
United Setting Facility Modifier None Typical Low $50.12 Median $64.57 Typical High $102.33 | Facility | None | $50.12 | $64.57 | $102.33 |
United Setting Professional Modifier None (both parts) Typical Low $28.84 Median $42.66 Typical High $52.48 | Professional | None (both parts) | $28.84 | $42.66 | $52.48 |
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 $21.38 Median $21.38 Typical High $26.30 | Professional | 52 · Reduced service | $21.38 | $21.38 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $10.47 | Professional | 53 · Discontinued | $8.51 | $8.51 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $7.76 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $5.25 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $25.12 Median $26.30 Typical High $61.66 | Professional | 26 · Professional part | $25.12 | $26.30 | $61.66 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $74.13 Median $95.50 Typical High $229.09 | Professional | 50 · Both sides | $74.13 | $95.50 | $229.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $24.55 Median $31.62 Typical High $77.62 | Professional | 51 · Multiple procedures | $24.55 | $31.62 | $77.62 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.77 Median $12.59 Typical High $30.90 | Professional | 80 · Assistant surgeon | $9.77 | $12.59 | $30.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.92 Median $8.91 Typical High $21.38 | Professional | 81 · Minimal assistant surgeon | $6.92 | $8.91 | $21.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.92 Median $8.91 Typical High $21.38 | Professional | 82 · Assistant surgeon, no resident | $6.92 | $8.91 | $21.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.92 Median $8.91 Typical High $21.38 | Professional | AS · PA/NP assist | $6.92 | $8.91 | $21.38 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $38.02 Median $38.90 Typical High $93.33 | Professional | TC · Technical part | $38.02 | $38.90 | $93.33 |
Where South Carolina sits
The same service costs 4.7 times more in Hawaii 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· 25th of 51
$50.12
HI $166DE $35.48
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.