How much rates vary
Facilitymedian $39 · 10th to 90th $29 to $59Professionalmedian $35 · 10th to 90th $28 to $59
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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None (both parts) Typical Low $28.84 Median $28.84 Typical High $36.31 | Professional | None (both parts) | $28.84 | $28.84 | $36.31 |
BCBS South Carolina Setting Facility Modifier None Typical Low $53.70 Median $58.88 Typical High $58.88 | Facility | None | $53.70 | $58.88 | $58.88 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $34.67 Median $50.12 Typical High $58.88 | Professional | None (both parts) | $34.67 | $50.12 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None (both parts) Typical Low $28.18 Median $28.18 Typical High $38.90 | Professional | None (both parts) | $28.18 | $28.18 | $38.90 |
Medcost Setting Professional Modifier None Typical Low $34.67 Median $38.90 Typical High $38.90 | Professional | None | $34.67 | $38.90 | $38.90 |
Medcost Setting Facility Modifier None Typical Low $18.62 Median $34.67 Typical High $72.44 | Facility | None | $18.62 | $34.67 | $72.44 |
Medcost Setting Professional Modifier None (both parts) Typical Low $33.11 Median $41.69 Typical High $77.62 | Professional | None (both parts) | $33.11 | $41.69 | $77.62 |
Molina Setting Professional Modifier None (both parts) Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None (both parts) | $39.81 | $39.81 | $39.81 |
United Setting Facility Modifier None Typical Low $35.48 Median $38.02 Typical High $79.43 | Facility | None | $35.48 | $38.02 | $79.43 |
United Setting Professional Modifier None (both parts) Typical Low $22.39 Median $28.84 Typical High $36.31 | Professional | None (both parts) | $22.39 | $28.84 | $36.31 |
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 $14.45 Median $14.45 Typical High $17.78 | Professional | 52 · Reduced service | $14.45 | $14.45 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $7.24 | Professional | 53 · Discontinued | $5.75 | $5.75 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $5.37 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $3.63 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $16.98 Median $17.38 Typical High $41.69 | Professional | 26 · Professional part | $16.98 | $17.38 | $41.69 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $48.98 Median $63.10 Typical High $154.88 | Professional | 50 · Both sides | $48.98 | $63.10 | $154.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $16.60 Median $20.89 Typical High $51.29 | Professional | 51 · Multiple procedures | $16.60 | $20.89 | $51.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.61 Median $8.32 Typical High $20.42 | Professional | 80 · Assistant surgeon | $6.61 | $8.32 | $20.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.57 Median $5.89 Typical High $14.45 | Professional | 81 · Minimal assistant surgeon | $4.57 | $5.89 | $14.45 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.57 Median $5.89 Typical High $14.45 | Professional | 82 · Assistant surgeon, no resident | $4.57 | $5.89 | $14.45 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.57 Median $5.89 Typical High $14.45 | Professional | AS · PA/NP assist | $4.57 | $5.89 | $14.45 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $25.12 Median $26.30 Typical High $61.66 | Professional | TC · Technical part | $25.12 | $26.30 | $61.66 |
Where South Carolina sits
The same service costs 3.0 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· 35th of 51
$34.67
HI $83.18DE $28.18
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.