How much rates vary
Facilitymedian $21 · 10th to 90th $19 to $39Professionalmedian $20 · 10th to 90th $17 to $39
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 $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None (both parts) Typical Low $19.05 Median $19.05 Typical High $22.91 | Professional | None (both parts) | $19.05 | $19.05 | $22.91 |
BCBS South Carolina Setting Facility Modifier None Typical Low $35.48 Median $38.90 Typical High $38.90 | Facility | None | $35.48 | $38.90 | $38.90 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $19.95 Median $28.84 Typical High $38.90 | Professional | None (both parts) | $19.95 | $28.84 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Cigna Setting Professional Modifier None (both parts) Typical Low $15.49 Median $15.49 Typical High $22.91 | Professional | None (both parts) | $15.49 | $15.49 | $22.91 |
Medcost Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Medcost Setting Facility Modifier None Typical Low $10.96 Median $21.38 Typical High $47.86 | Facility | None | $10.96 | $21.38 | $47.86 |
Medcost Setting Professional Modifier None (both parts) Typical Low $21.88 Median $28.84 Typical High $51.29 | Professional | None (both parts) | $21.88 | $28.84 | $51.29 |
Molina Setting Professional Modifier None (both parts) Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None (both parts) | $26.30 | $26.30 | $26.30 |
United Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
United Setting Professional Modifier None (both parts) Typical Low $13.18 Median $18.62 Typical High $22.91 | Professional | None (both parts) | $13.18 | $18.62 | $22.91 |
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 $9.55 Median $9.55 Typical High $11.48 | Professional | 52 · Reduced service | $9.55 | $9.55 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $4.57 | Professional | 53 · Discontinued | $3.80 | $3.80 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $2.88 Typical High $3.47 | Professional | 55 · Aftercare only | $2.88 | $2.88 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $2.29 | Professional | 56 · Pre-op care only | $1.91 | $1.91 | $2.29 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $11.48 Median $11.48 Typical High $27.54 | Professional | 26 · Professional part | $11.48 | $11.48 | $27.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $33.11 Median $43.65 Typical High $102.33 | Professional | 50 · Both sides | $33.11 | $43.65 | $102.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $10.96 Median $14.45 Typical High $33.88 | Professional | 51 · Multiple procedures | $10.96 | $14.45 | $33.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.37 Median $5.75 Typical High $13.49 | Professional | 80 · Assistant surgeon | $4.37 | $5.75 | $13.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.09 Median $4.07 Typical High $9.55 | Professional | 81 · Minimal assistant surgeon | $3.09 | $4.07 | $9.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.09 Median $4.07 Typical High $9.55 | Professional | 82 · Assistant surgeon, no resident | $3.09 | $4.07 | $9.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.09 Median $4.07 Typical High $9.55 | Professional | AS · PA/NP assist | $3.09 | $4.07 | $9.55 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $16.98 Median $17.38 Typical High $40.74 | Professional | TC · Technical part | $16.98 | $17.38 | $40.74 |
Where South Carolina sits
The same service costs 3.1 times more in Montana 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· 36th of 51
$20.42
MT $40.74KS $13.18
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.