How much rates vary
Facilitymedian $9 · 10th to 90th $5 to $12Professionalmedian $19 · 10th to 90th $5 to $26
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 $4.57 Median $4.57 Typical High $4.57 | Facility | None | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier None (both parts) Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | None (both parts) | $4.57 | $4.57 | $4.57 |
BCBS South Carolina Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $12.30 Median $22.91 Typical High $25.70 | Professional | None (both parts) | $12.30 | $22.91 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Cigna Setting Professional Modifier None (both parts) Typical Low $6.76 Median $6.76 Typical High $9.33 | Professional | None (both parts) | $6.76 | $6.76 | $9.33 |
Medcost Setting Facility Modifier None Typical Low $4.57 Median $4.57 Typical High $6.46 | Facility | None | $4.57 | $4.57 | $6.46 |
Medcost Setting Professional Modifier None (both parts) Typical Low $8.91 Median $10.72 Typical High $13.18 | Professional | None (both parts) | $8.91 | $10.72 | $13.18 |
Molina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None (both parts) | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier None (both parts) Typical Low $3.72 Median $5.50 Typical High $11.48 | Professional | None (both parts) | $3.72 | $5.50 | $11.48 |
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 $2.29 Median $2.29 Typical High $2.29 | Professional | 52 · Reduced service | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | 53 · Discontinued | $0.91 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 55 · Aftercare only | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | 56 · Pre-op care only | $0.45 | $0.45 | $0.45 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $3.55 Median $4.17 Typical High $5.25 | Professional | 26 · Professional part | $3.55 | $4.17 | $5.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $13.18 Median $16.22 Typical High $19.50 | Professional | 50 · Both sides | $13.18 | $16.22 | $19.50 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4.47 Median $5.37 Typical High $6.61 | Professional | 51 · Multiple procedures | $4.47 | $5.37 | $6.61 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.78 Median $2.14 Typical High $2.63 | Professional | 80 · Assistant surgeon | $1.78 | $2.14 | $2.63 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.23 Median $1.51 Typical High $1.82 | Professional | 81 · Minimal assistant surgeon | $1.23 | $1.51 | $1.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.23 Median $1.51 Typical High $1.82 | Professional | 82 · Assistant surgeon, no resident | $1.23 | $1.51 | $1.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.23 Median $1.51 Typical High $1.82 | Professional | AS · PA/NP assist | $1.23 | $1.51 | $1.82 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $5.25 Median $6.31 Typical High $7.94 | Professional | TC · Technical part | $5.25 | $6.31 | $7.94 |
Where South Carolina sits
The same service costs 39.8 times more in New York than in Hawaii. 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· 7th of 51
$13.18
NY $126HI $3.16
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.