How much rates vary
Facilitymedian $102 · 10th to 90th $72 to $151Professionalmedian $85 · 10th to 90th $72 to $151
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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None (both parts) Typical Low $72.44 Median $72.44 Typical High $104.71 | Professional | None (both parts) | $72.44 | $72.44 | $104.71 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None (both parts) | $112.20 | $112.20 | $112.20 |
BCBS South Carolina Setting Facility Modifier None Typical Low $134.90 Median $151.36 Typical High $151.36 | Facility | None | $134.90 | $151.36 | $151.36 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $85.11 Median $123.03 Typical High $151.36 | Professional | None (both parts) | $85.11 | $123.03 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None (both parts) Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | None (both parts) | $74.13 | $74.13 | $102.33 |
Medcost Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | None | $74.13 | $74.13 | $89.13 |
Medcost Setting Facility Modifier None Typical Low $45.71 Median $87.10 Typical High $181.97 | Facility | None | $45.71 | $87.10 | $181.97 |
Medcost Setting Professional Modifier None (both parts) Typical Low $83.18 Median $107.15 Typical High $194.98 | Professional | None (both parts) | $83.18 | $107.15 | $194.98 |
Molina Setting Professional Modifier None (both parts) Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None (both parts) | $100.00 | $100.00 | $100.00 |
United Setting Facility Modifier None Typical Low $87.10 Median $190.55 Typical High $190.55 | Facility | None | $87.10 | $190.55 | $190.55 |
United Setting Professional Modifier None (both parts) Typical Low $53.70 Median $72.44 Typical High $89.13 | Professional | None (both parts) | $53.70 | $72.44 | $89.13 |
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 $36.31 Median $36.31 Typical High $44.67 | Professional | 52 · Reduced service | $36.31 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $17.78 | Professional | 53 · Discontinued | $14.45 | $14.45 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $13.18 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $8.91 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $42.66 Median $44.67 Typical High $104.71 | Professional | 26 · Professional part | $42.66 | $44.67 | $104.71 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $162.18 Typical High $389.05 | Professional | 50 · Both sides | $125.89 | $162.18 | $389.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $41.69 Median $54.95 Typical High $131.83 | Professional | 51 · Multiple procedures | $41.69 | $54.95 | $131.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.60 Median $21.88 Typical High $52.48 | Professional | 80 · Assistant surgeon | $16.60 | $21.88 | $52.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.75 Median $15.14 Typical High $36.31 | Professional | 81 · Minimal assistant surgeon | $11.75 | $15.14 | $36.31 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.75 Median $15.14 Typical High $36.31 | Professional | 82 · Assistant surgeon, no resident | $11.75 | $15.14 | $36.31 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $11.75 Median $15.14 Typical High $36.31 | Professional | AS · PA/NP assist | $11.75 | $15.14 | $36.31 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $63.10 Median $66.07 Typical High $154.88 | Professional | TC · Technical part | $63.10 | $66.07 | $154.88 |
Where South Carolina sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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
$85.11
HI $214NJ $74.13
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.