How much rates vary
Facilitymedian $49 · 10th to 90th $30 to $62Professionalmedian $35 · 10th to 90th $30 to $62
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 $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier None (both parts) Typical Low $30.20 Median $30.20 Typical High $38.90 | Professional | None (both parts) | $30.20 | $30.20 | $38.90 |
BCBS South Carolina Setting Facility Modifier None Typical Low $54.95 Median $61.66 Typical High $61.66 | Facility | None | $54.95 | $61.66 | $61.66 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $34.67 Median $50.12 Typical High $61.66 | Professional | None (both parts) | $34.67 | $50.12 | $61.66 |
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 $48.98 | Professional | None (both parts) | $35.48 | $35.48 | $48.98 |
Medcost Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $37.15 | Professional | None | $30.20 | $30.20 | $37.15 |
Medcost Setting Facility Modifier None Typical Low $19.50 Median $33.88 Typical High $74.13 | Facility | None | $19.50 | $33.88 | $74.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $33.88 Median $43.65 Typical High $81.28 | Professional | None (both parts) | $33.88 | $43.65 | $81.28 |
Molina Setting Professional Modifier None (both parts) Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None (both parts) | $40.74 | $40.74 | $40.74 |
United Setting Facility Modifier None Typical Low $40.74 Median $52.48 Typical High $83.18 | Facility | None | $40.74 | $52.48 | $83.18 |
United Setting Professional Modifier None (both parts) Typical Low $23.44 Median $30.20 Typical High $38.02 | Professional | None (both parts) | $23.44 | $30.20 | $38.02 |
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 $15.14 Median $15.14 Typical High $18.62 | Professional | 52 · Reduced service | $15.14 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $7.41 | Professional | 53 · Discontinued | $6.03 | $6.03 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $5.62 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $3.72 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $17.78 Median $18.20 Typical High $42.66 | Professional | 26 · Professional part | $17.78 | $18.20 | $42.66 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $51.29 Median $66.07 Typical High $162.18 | Professional | 50 · Both sides | $51.29 | $66.07 | $162.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $16.98 Median $21.88 Typical High $53.70 | Professional | 51 · Multiple procedures | $16.98 | $21.88 | $53.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.76 Median $8.71 Typical High $21.38 | Professional | 80 · Assistant surgeon | $6.76 | $8.71 | $21.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.79 Median $6.17 Typical High $15.14 | Professional | 81 · Minimal assistant surgeon | $4.79 | $6.17 | $15.14 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.79 Median $6.17 Typical High $15.14 | Professional | 82 · Assistant surgeon, no resident | $4.79 | $6.17 | $15.14 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.79 Median $6.17 Typical High $15.14 | Professional | AS · PA/NP assist | $4.79 | $6.17 | $15.14 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $26.30 Median $27.54 Typical High $64.57 | Professional | TC · Technical part | $26.30 | $27.54 | $64.57 |
Where South Carolina sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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· 41st of 51
$35.48
HI $132DC $33.11
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.