How much rates vary
Facilitymedian $98 · 10th to 90th $74 to $155Professionalmedian $89 · 10th to 90th $71 to $155
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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None (both parts) Typical Low $74.13 Median $74.13 Typical High $95.50 | Professional | None (both parts) | $74.13 | $74.13 | $95.50 |
BCBS South Carolina Setting Facility Modifier None Typical Low $138.04 Median $154.88 Typical High $154.88 | Facility | None | $138.04 | $154.88 | $154.88 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $89.13 Median $128.82 Typical High $154.88 | Professional | None (both parts) | $89.13 | $128.82 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None (both parts) Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None (both parts) | $70.79 | $70.79 | $97.72 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $97.72 | Professional | None | $91.20 | $97.72 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $48.98 Median $87.10 Typical High $186.21 | Facility | None | $48.98 | $87.10 | $186.21 |
Medcost Setting Professional Modifier None (both parts) Typical Low $85.11 Median $109.65 Typical High $199.53 | Professional | None (both parts) | $85.11 | $109.65 | $199.53 |
Molina Setting Professional Modifier None (both parts) Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None (both parts) | $102.33 | $102.33 | $102.33 |
United Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $204.17 | Facility | None | $95.50 | $100.00 | $204.17 |
United Setting Professional Modifier None (both parts) Typical Low $57.54 Median $75.86 Typical High $95.50 | Professional | None (both parts) | $57.54 | $75.86 | $95.50 |
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 $37.15 Median $37.15 Typical High $46.77 | Professional | 52 · Reduced service | $37.15 | $37.15 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $18.62 | Professional | 53 · Discontinued | $14.79 | $14.79 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $13.80 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $9.33 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $43.65 Median $45.71 Typical High $107.15 | Professional | 26 · Professional part | $43.65 | $45.71 | $107.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $128.82 Median $162.18 Typical High $398.11 | Professional | 50 · Both sides | $128.82 | $162.18 | $398.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $42.66 Median $54.95 Typical High $134.90 | Professional | 51 · Multiple procedures | $42.66 | $54.95 | $134.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.98 Median $21.88 Typical High $53.70 | Professional | 80 · Assistant surgeon | $16.98 | $21.88 | $53.70 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.02 Median $15.14 Typical High $37.15 | Professional | 81 · Minimal assistant surgeon | $12.02 | $15.14 | $37.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.02 Median $15.14 Typical High $37.15 | Professional | 82 · Assistant surgeon, no resident | $12.02 | $15.14 | $37.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.02 Median $15.14 Typical High $37.15 | Professional | AS · PA/NP assist | $12.02 | $15.14 | $37.15 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $66.07 Median $67.61 Typical High $158.49 | Professional | TC · Technical part | $66.07 | $67.61 | $158.49 |
Where South Carolina sits
The same service costs 3.2 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· 41st of 51
$89.13
HI $224FL $70.79
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.