How much rates vary
Facilitymedian $56 · 10th to 90th $45 to $91Professionalmedian $47 · 10th to 90th $41 to $91
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 $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None (both parts) Typical Low $44.67 Median $44.67 Typical High $53.70 | Professional | None (both parts) | $44.67 | $44.67 | $53.70 |
BCBS South Carolina Setting Facility Modifier None Typical Low $17.78 Median $85.11 Typical High $91.20 | Facility | None | $17.78 | $85.11 | $91.20 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $46.77 Median $67.61 Typical High $91.20 | Professional | None (both parts) | $46.77 | $67.61 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None (both parts) Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None (both parts) | $40.74 | $40.74 | $56.23 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Medcost Setting Facility Modifier None Typical Low $25.70 Median $50.12 Typical High $109.65 | Facility | None | $25.70 | $50.12 | $109.65 |
Medcost Setting Professional Modifier None (both parts) Typical Low $52.48 Median $67.61 Typical High $120.23 | Professional | None (both parts) | $52.48 | $67.61 | $120.23 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
United Setting Professional Modifier None (both parts) Typical Low $30.20 Median $43.65 Typical High $53.70 | Professional | None (both parts) | $30.20 | $43.65 | $53.70 |
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 $21.88 Median $21.88 Typical High $26.92 | Professional | 52 · Reduced service | $21.88 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $10.72 | Professional | 53 · Discontinued | $8.91 | $8.91 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $7.94 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $5.37 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $26.30 Median $26.92 Typical High $63.10 | Professional | 26 · Professional part | $26.30 | $26.92 | $63.10 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $77.62 Median $102.33 Typical High $239.88 | Professional | 50 · Both sides | $77.62 | $102.33 | $239.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $25.70 Median $33.88 Typical High $79.43 | Professional | 51 · Multiple procedures | $25.70 | $33.88 | $79.43 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.47 Median $13.49 Typical High $31.62 | Professional | 80 · Assistant surgeon | $10.47 | $13.49 | $31.62 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.24 Median $9.55 Typical High $22.39 | Professional | 81 · Minimal assistant surgeon | $7.24 | $9.55 | $22.39 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.24 Median $9.55 Typical High $22.39 | Professional | 82 · Assistant surgeon, no resident | $7.24 | $9.55 | $22.39 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.24 Median $9.55 Typical High $22.39 | Professional | AS · PA/NP assist | $7.24 | $9.55 | $22.39 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $39.81 Median $40.74 Typical High $95.50 | Professional | TC · Technical part | $39.81 | $40.74 | $95.50 |
Where South Carolina sits
The same service costs 3.1 times more in Hawaii than in Kansas. 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· 35th of 51
$46.77
HI $93.33KS $30.20
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.