How much rates vary
Facilitymedian $35 · 10th to 90th $26 to $54Professionalmedian $31 · 10th to 90th $26 to $54
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 $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None (both parts) Typical Low $25.70 Median $25.70 Typical High $33.11 | Professional | None (both parts) | $25.70 | $25.70 | $33.11 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None (both parts) | $54.95 | $54.95 | $54.95 |
BCBS South Carolina Setting Facility Modifier None Typical Low $47.86 Median $53.70 Typical High $53.70 | Facility | None | $47.86 | $53.70 | $53.70 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $28.18 Median $35.48 Typical High $53.70 | Professional | None (both parts) | $28.18 | $35.48 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None (both parts) Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None (both parts) | $25.70 | $25.70 | $34.67 |
Medcost Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Medcost Setting Facility Modifier None Typical Low $15.14 Median $28.84 Typical High $64.57 | Facility | None | $15.14 | $28.84 | $64.57 |
Medcost Setting Professional Modifier None (both parts) Typical Low $30.20 Median $39.81 Typical High $69.18 | Professional | None (both parts) | $30.20 | $39.81 | $69.18 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
United Setting Professional Modifier None (both parts) Typical Low $17.78 Median $25.70 Typical High $31.62 | Professional | None (both parts) | $17.78 | $25.70 | $31.62 |
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 $12.88 Median $12.88 Typical High $15.85 | Professional | 52 · Reduced service | $12.88 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $6.31 | Professional | 53 · Discontinued | $5.13 | $5.13 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $4.68 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $3.16 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $15.49 Median $15.85 Typical High $37.15 | Professional | 26 · Professional part | $15.49 | $15.85 | $37.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $44.67 Median $60.26 Typical High $138.04 | Professional | 50 · Both sides | $44.67 | $60.26 | $138.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.14 Median $19.95 Typical High $46.77 | Professional | 51 · Multiple procedures | $15.14 | $19.95 | $46.77 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.03 Median $7.94 Typical High $18.62 | Professional | 80 · Assistant surgeon | $6.03 | $7.94 | $18.62 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.17 Median $5.62 Typical High $12.88 | Professional | 81 · Minimal assistant surgeon | $4.17 | $5.62 | $12.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.17 Median $5.62 Typical High $12.88 | Professional | 82 · Assistant surgeon, no resident | $4.17 | $5.62 | $12.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.17 Median $5.62 Typical High $12.88 | Professional | AS · PA/NP assist | $4.17 | $5.62 | $12.88 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $23.44 Median $23.99 Typical High $56.23 | Professional | TC · Technical part | $23.44 | $23.99 | $56.23 |
Where South Carolina sits
The same service costs 2.1 times more in Montana than in New Jersey. 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· 25th of 51
$31.62
MT $54.95NJ $25.70
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.