How much rates vary
Facilitymedian $107 · 10th to 90th $66 to $182Professionalmedian $79 · 10th to 90th $66 to $135
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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None (both parts) Typical Low $66.07 Median $66.07 Typical High $81.28 | Professional | None (both parts) | $66.07 | $66.07 | $81.28 |
BCBS South Carolina Setting Facility Modifier None Typical Low $123.03 Median $134.90 Typical High $134.90 | Facility | None | $123.03 | $134.90 | $134.90 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $79.43 Median $114.82 Typical High $134.90 | Professional | None (both parts) | $79.43 | $114.82 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None (both parts) Typical Low $77.62 Median $77.62 Typical High $107.15 | Professional | None (both parts) | $77.62 | $77.62 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $89.13 | Professional | None | $79.43 | $89.13 | $89.13 |
Medcost Setting Facility Modifier None Typical Low $42.66 Median $75.86 Typical High $162.18 | Facility | None | $42.66 | $75.86 | $162.18 |
Medcost Setting Professional Modifier None (both parts) Typical Low $75.86 Median $95.50 Typical High $177.83 | Professional | None (both parts) | $75.86 | $95.50 | $177.83 |
Molina Setting Professional Modifier None (both parts) Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None (both parts) | $89.13 | $89.13 | $89.13 |
United Setting Facility Modifier None Typical Low $89.13 Median $181.97 Typical High $870.96 | Facility | None | $89.13 | $181.97 | $870.96 |
United Setting Professional Modifier None (both parts) Typical Low $51.29 Median $66.07 Typical High $83.18 | Professional | None (both parts) | $51.29 | $66.07 | $83.18 |
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 $33.11 Median $33.11 Typical High $40.74 | Professional | 52 · Reduced service | $33.11 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $16.60 | Professional | 53 · Discontinued | $13.18 | $13.18 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $12.30 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $8.13 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $38.02 Median $39.81 Typical High $93.33 | Professional | 26 · Professional part | $38.02 | $39.81 | $93.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $144.54 Typical High $354.81 | Professional | 50 · Both sides | $112.20 | $144.54 | $354.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $37.15 Median $47.86 Typical High $117.49 | Professional | 51 · Multiple procedures | $37.15 | $47.86 | $117.49 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.14 Median $19.05 Typical High $46.77 | Professional | 80 · Assistant surgeon | $15.14 | $19.05 | $46.77 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.47 Median $13.49 Typical High $33.11 | Professional | 81 · Minimal assistant surgeon | $10.47 | $13.49 | $33.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.47 Median $13.49 Typical High $33.11 | Professional | 82 · Assistant surgeon, no resident | $10.47 | $13.49 | $33.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.47 Median $13.49 Typical High $33.11 | Professional | AS · PA/NP assist | $10.47 | $13.49 | $33.11 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $57.54 Median $60.26 Typical High $141.25 | Professional | TC · Technical part | $57.54 | $60.26 | $141.25 |
Where South Carolina sits
The same service costs 5.1 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· 38th of 51
$79.43
HI $355FL $69.18
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.