How much rates vary
Facilitymedian $63 · 10th to 90th $48 to $98Professionalmedian $56 · 10th to 90th $46 to $98
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 $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None (both parts) Typical Low $47.86 Median $47.86 Typical High $61.66 | Professional | None (both parts) | $47.86 | $47.86 | $61.66 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $75.86 Median $75.86 Typical High $79.43 | Professional | None (both parts) | $75.86 | $75.86 | $79.43 |
BCBS South Carolina Setting Facility Modifier None Typical Low $87.10 Median $97.72 Typical High $97.72 | Facility | None | $87.10 | $97.72 | $97.72 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $56.23 Median $83.18 Typical High $97.72 | Professional | None (both parts) | $56.23 | $83.18 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $63.10 Typical High $63.10 | Facility | None | $56.23 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None (both parts) Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None (both parts) | $45.71 | $45.71 | $63.10 |
Medcost Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $58.88 | Professional | None | $54.95 | $54.95 | $58.88 |
Medcost Setting Facility Modifier None Typical Low $30.90 Median $53.70 Typical High $117.49 | Facility | None | $30.90 | $53.70 | $117.49 |
Medcost Setting Professional Modifier None (both parts) Typical Low $53.70 Median $69.18 Typical High $128.82 | Professional | None (both parts) | $53.70 | $69.18 | $128.82 |
Molina Setting Professional Modifier None (both parts) Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None (both parts) | $64.57 | $64.57 | $64.57 |
United Setting Facility Modifier None Typical Low $60.26 Median $63.10 Typical High $128.82 | Facility | None | $60.26 | $63.10 | $128.82 |
United Setting Professional Modifier None (both parts) Typical Low $36.31 Median $47.86 Typical High $60.26 | Professional | None (both parts) | $36.31 | $47.86 | $60.26 |
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 $23.44 Median $23.44 Typical High $28.84 | Professional | 52 · Reduced service | $23.44 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $11.48 | Professional | 53 · Discontinued | $9.55 | $9.55 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $8.71 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $5.75 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $27.54 Median $28.84 Typical High $67.61 | Professional | 26 · Professional part | $27.54 | $28.84 | $67.61 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $81.28 Median $102.33 Typical High $257.04 | Professional | 50 · Both sides | $81.28 | $102.33 | $257.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.92 Median $34.67 Typical High $85.11 | Professional | 51 · Multiple procedures | $26.92 | $34.67 | $85.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.72 Median $13.80 Typical High $33.88 | Professional | 80 · Assistant surgeon | $10.72 | $13.80 | $33.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.59 Median $9.55 Typical High $23.99 | Professional | 81 · Minimal assistant surgeon | $7.59 | $9.55 | $23.99 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.59 Median $9.55 Typical High $23.99 | Professional | 82 · Assistant surgeon, no resident | $7.59 | $9.55 | $23.99 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.59 Median $9.55 Typical High $23.99 | Professional | AS · PA/NP assist | $7.59 | $9.55 | $23.99 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $41.69 Median $43.65 Typical High $102.33 | Professional | TC · Technical part | $41.69 | $43.65 | $102.33 |
Where South Carolina sits
The same service costs 3.8 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· 39th of 51
$56.23
HI $174FL $45.71
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.