How much rates vary
Facilitymedian $71 · 10th to 90th $49 to $100Professionalmedian $52 · 10th to 90th $47 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 $60.26 | Professional | None (both parts) | $48.98 | $48.98 | $60.26 |
BCBS South Carolina Setting Facility Modifier None Typical Low $91.20 Median $100.00 Typical High $100.00 | Facility | None | $91.20 | $100.00 | $100.00 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $52.48 Median $74.13 Typical High $100.00 | Professional | None (both parts) | $52.48 | $74.13 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None (both parts) Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None (both parts) | $51.29 | $51.29 | $70.79 |
Medcost Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Medcost Setting Facility Modifier None Typical Low $28.18 Median $54.95 Typical High $120.23 | Facility | None | $28.18 | $54.95 | $120.23 |
Medcost Setting Professional Modifier None (both parts) Typical Low $57.54 Median $75.86 Typical High $131.83 | Professional | None (both parts) | $57.54 | $75.86 | $131.83 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
United Setting Professional Modifier None (both parts) Typical Low $33.88 Median $47.86 Typical High $58.88 | Professional | None (both parts) | $33.88 | $47.86 | $58.88 |
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 $24.55 Median $24.55 Typical High $29.51 | Professional | 52 · Reduced service | $24.55 | $24.55 | $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 $8.91 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $5.89 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $29.51 Median $30.20 Typical High $69.18 | Professional | 26 · Professional part | $29.51 | $30.20 | $69.18 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $85.11 Median $112.20 Typical High $263.03 | Professional | 50 · Both sides | $85.11 | $112.20 | $263.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $28.18 Median $37.15 Typical High $87.10 | Professional | 51 · Multiple procedures | $28.18 | $37.15 | $87.10 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.48 Median $15.14 Typical High $34.67 | Professional | 80 · Assistant surgeon | $11.48 | $15.14 | $34.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.94 Median $10.47 Typical High $24.55 | Professional | 81 · Minimal assistant surgeon | $7.94 | $10.47 | $24.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.94 Median $10.47 Typical High $24.55 | Professional | 82 · Assistant surgeon, no resident | $7.94 | $10.47 | $24.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.94 Median $10.47 Typical High $24.55 | Professional | AS · PA/NP assist | $7.94 | $10.47 | $24.55 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $43.65 Median $44.67 Typical High $104.71 | Professional | TC · Technical part | $43.65 | $44.67 | $104.71 |
Where South Carolina sits
The same service costs 2.0 times more in Hawaii than in West Virginia. 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· 37th of 51
$52.48
HI $102WV $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.