How much rates vary
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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None (both parts) Typical Low $46.77 Median $46.77 Typical High $57.54 | Professional | None (both parts) | $46.77 | $46.77 | $57.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $87.10 Median $95.50 Typical High $95.50 | Facility | None | $87.10 | $95.50 | $95.50 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $54.95 Median $79.43 Typical High $95.50 | Professional | None (both parts) | $54.95 | $79.43 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None (both parts) Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None (both parts) | $58.88 | $58.88 | $81.28 |
Medcost Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Medcost Setting Facility Modifier None Typical Low $30.20 Median $56.23 Typical High $117.49 | Facility | None | $30.20 | $56.23 | $117.49 |
Medcost Setting Professional Modifier None (both parts) Typical Low $52.48 Median $67.61 Typical High $125.89 | Professional | None (both parts) | $52.48 | $67.61 | $125.89 |
United Setting Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $128.82 | Facility | None | $63.10 | $93.33 | $128.82 |
United Setting Professional Modifier None (both parts) Typical Low $36.31 Median $46.77 Typical High $58.88 | Professional | None (both parts) | $36.31 | $46.77 | $58.88 |
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 $23.44 Median $23.44 Typical High $28.84 | Professional | 52 · Reduced service | $23.44 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $11.75 | Professional | 53 · Discontinued | $9.33 | $9.33 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $8.71 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $5.75 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $28.18 Typical High $66.07 | Professional | 26 · Professional part | $26.92 | $28.18 | $66.07 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $79.43 Median $102.33 Typical High $251.19 | Professional | 50 · Both sides | $79.43 | $102.33 | $251.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.30 Median $33.88 Typical High $83.18 | Professional | 51 · Multiple procedures | $26.30 | $33.88 | $83.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.72 Median $13.49 Typical High $33.11 | Professional | 80 · Assistant surgeon | $10.72 | $13.49 | $33.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.41 Median $9.55 Typical High $23.44 | Professional | 81 · Minimal assistant surgeon | $7.41 | $9.55 | $23.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.41 Median $9.55 Typical High $23.44 | Professional | 82 · Assistant surgeon, no resident | $7.41 | $9.55 | $23.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.41 Median $9.55 Typical High $23.44 | Professional | AS · PA/NP assist | $7.41 | $9.55 | $23.44 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $40.74 Median $42.66 Typical High $100.00 | Professional | TC · Technical part | $40.74 | $42.66 | $100.00 |
Where South Carolina sits
The same service costs 4.4 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· 50th of 51
$54.95
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.