How much rates vary
Facilitymedian $117 · 10th to 90th $85 to $178Professionalmedian $85 · 10th to 90th $76 to $178
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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None (both parts) Typical Low $85.11 Median $85.11 Typical High $104.71 | Professional | None (both parts) | $85.11 | $85.11 | $104.71 |
BCBS South Carolina Setting Facility Modifier None Typical Low $158.49 Median $177.83 Typical High $177.83 | Facility | None | $158.49 | $177.83 | $177.83 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $75.86 Median $120.23 Typical High $177.83 | Professional | None (both parts) | $75.86 | $120.23 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None (both parts) Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None (both parts) | $85.11 | $85.11 | $117.49 |
Medcost Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $102.33 | Professional | None | $87.10 | $87.10 | $102.33 |
Medcost Setting Facility Modifier None Typical Low $50.12 Median $97.72 Typical High $213.80 | Facility | None | $50.12 | $97.72 | $213.80 |
Medcost Setting Professional Modifier None (both parts) Typical Low $67.61 Median $125.89 Typical High $229.09 | Professional | None (both parts) | $67.61 | $125.89 | $229.09 |
Molina Setting Professional Modifier None (both parts) Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None (both parts) | $109.65 | $109.65 | $109.65 |
United Setting Facility Modifier None Typical Low $57.54 Median $208.93 Typical High $208.93 | Facility | None | $57.54 | $208.93 | $208.93 |
United Setting Professional Modifier None (both parts) Typical Low $58.88 Median $85.11 Typical High $104.71 | Professional | None (both parts) | $58.88 | $85.11 | $104.71 |
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 $42.66 Median $42.66 Typical High $52.48 | Professional | 52 · Reduced service | $42.66 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $20.89 | Professional | 53 · Discontinued | $17.38 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $15.49 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $10.47 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $50.12 Median $52.48 Typical High $123.03 | Professional | 26 · Professional part | $50.12 | $52.48 | $123.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $186.21 Typical High $457.09 | Professional | 50 · Both sides | $100.00 | $186.21 | $457.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.88 Median $63.10 Typical High $154.88 | Professional | 51 · Multiple procedures | $33.88 | $63.10 | $154.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.49 Median $25.12 Typical High $61.66 | Professional | 80 · Assistant surgeon | $13.49 | $25.12 | $61.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.33 Median $17.38 Typical High $42.66 | Professional | 81 · Minimal assistant surgeon | $9.33 | $17.38 | $42.66 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.33 Median $17.38 Typical High $42.66 | Professional | 82 · Assistant surgeon, no resident | $9.33 | $17.38 | $42.66 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.33 Median $17.38 Typical High $42.66 | Professional | AS · PA/NP assist | $9.33 | $17.38 | $42.66 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $75.86 Median $77.62 Typical High $186.21 | Professional | TC · Technical part | $75.86 | $77.62 | $186.21 |
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· 50th of 51
$85.11
MT $178FL $85.11
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.