How much rates vary
Facilitymedian $72 · 10th to 90th $49 to $100Professionalmedian $60 · 10th to 90th $49 to $100
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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None (both parts) Typical Low $48.98 Median $48.98 Typical High $74.13 | Professional | None (both parts) | $48.98 | $48.98 | $74.13 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $79.43 Median $89.13 Typical High $89.13 | Professional | None (both parts) | $79.43 | $89.13 | $89.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $89.13 Median $100.00 Typical High $100.00 | Facility | None | $89.13 | $100.00 | $100.00 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $60.26 Median $87.10 Typical High $100.00 | Professional | None (both parts) | $60.26 | $87.10 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None (both parts) Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None (both parts) | $52.48 | $52.48 | $72.44 |
Medcost Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $58.88 | Professional | None | $48.98 | $48.98 | $58.88 |
Medcost Setting Facility Modifier None Typical Low $31.62 Median $54.95 Typical High $120.23 | Facility | None | $31.62 | $54.95 | $120.23 |
Medcost Setting Professional Modifier None (both parts) Typical Low $54.95 Median $70.79 Typical High $117.49 | Professional | None (both parts) | $54.95 | $70.79 | $117.49 |
Molina Setting Professional Modifier None (both parts) Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None (both parts) | $66.07 | $66.07 | $66.07 |
United Setting Facility Modifier None Typical Low $64.57 Median $100.00 Typical High $131.83 | Facility | None | $64.57 | $100.00 | $131.83 |
United Setting Professional Modifier None (both parts) Typical Low $37.15 Median $48.98 Typical High $61.66 | Professional | None (both parts) | $37.15 | $48.98 | $61.66 |
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 $23.99 Median $23.99 Typical High $29.51 | Professional | 52 · Reduced service | $23.99 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $11.75 | Professional | 53 · Discontinued | $9.77 | $9.77 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $8.71 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $5.89 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $28.18 Median $29.51 Typical High $69.18 | Professional | 26 · Professional part | $28.18 | $29.51 | $69.18 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $83.18 Median $107.15 Typical High $257.04 | Professional | 50 · Both sides | $83.18 | $107.15 | $257.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $27.54 Median $36.31 Typical High $87.10 | Professional | 51 · Multiple procedures | $27.54 | $36.31 | $87.10 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.96 Median $14.13 Typical High $34.67 | Professional | 80 · Assistant surgeon | $10.96 | $14.13 | $34.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.76 Median $10.00 Typical High $23.99 | Professional | 81 · Minimal assistant surgeon | $7.76 | $10.00 | $23.99 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.76 Median $10.00 Typical High $23.99 | Professional | 82 · Assistant surgeon, no resident | $7.76 | $10.00 | $23.99 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.76 Median $10.00 Typical High $23.99 | Professional | AS · PA/NP assist | $7.76 | $10.00 | $23.99 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $42.66 Median $43.65 Typical High $104.71 | Professional | TC · Technical part | $42.66 | $43.65 | $104.71 |
Where South Carolina sits
The same service costs 5.0 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· 33rd of 51
$60.26
HI $257FL $51.29
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.