How much rates vary
Facilitymedian $68 · 10th to 90th $52 to $107Professionalmedian $52 · 10th to 90th $35 to $107
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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None (both parts) Typical Low $52.48 Median $52.48 Typical High $63.10 | Professional | None (both parts) | $52.48 | $52.48 | $63.10 |
BCBS South Carolina Setting Facility Modifier None Typical Low $97.72 Median $107.15 Typical High $107.15 | Facility | None | $97.72 | $107.15 | $107.15 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $34.67 Median $57.54 Typical High $107.15 | Professional | None (both parts) | $34.67 | $57.54 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None (both parts) Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None (both parts) | $50.12 | $50.12 | $67.61 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $61.66 | Professional | None | $52.48 | $52.48 | $61.66 |
Medcost Setting Facility Modifier None Typical Low $30.20 Median $58.88 Typical High $128.82 | Facility | None | $30.20 | $58.88 | $128.82 |
Medcost Setting Professional Modifier None (both parts) Typical Low $33.88 Median $75.86 Typical High $141.25 | Professional | None (both parts) | $33.88 | $75.86 | $141.25 |
Molina Setting Professional Modifier None (both parts) Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None (both parts) | $70.79 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $32.36 Median $60.26 Typical High $128.82 | Facility | None | $32.36 | $60.26 | $128.82 |
United Setting Professional Modifier None (both parts) Typical Low $36.31 Median $51.29 Typical High $63.10 | Professional | None (both parts) | $36.31 | $51.29 | $63.10 |
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 $26.30 Median $26.30 Typical High $31.62 | Professional | 52 · Reduced service | $26.30 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $12.59 | Professional | 53 · Discontinued | $10.47 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $9.55 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $6.31 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $30.20 Median $31.62 Typical High $74.13 | Professional | 26 · Professional part | $30.20 | $31.62 | $74.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $51.29 Median $114.82 Typical High $281.84 | Professional | 50 · Both sides | $51.29 | $114.82 | $281.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $16.98 Median $38.02 Typical High $93.33 | Professional | 51 · Multiple procedures | $16.98 | $38.02 | $93.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.76 Median $15.14 Typical High $37.15 | Professional | 80 · Assistant surgeon | $6.76 | $15.14 | $37.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.79 Median $10.72 Typical High $26.30 | Professional | 81 · Minimal assistant surgeon | $4.79 | $10.72 | $26.30 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.79 Median $10.72 Typical High $26.30 | Professional | 82 · Assistant surgeon, no resident | $4.79 | $10.72 | $26.30 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.79 Median $10.72 Typical High $26.30 | Professional | AS · PA/NP assist | $4.79 | $10.72 | $26.30 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $45.71 Median $47.86 Typical High $112.20 | Professional | TC · Technical part | $45.71 | $47.86 | $112.20 |
Where South Carolina sits
The same service costs 2.1 times more in Montana 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· 45th of 51
$52.48
MT $107FL $50.12
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.