How much rates vary
Facilitymedian $34 · 10th to 90th $30 to $63Professionalmedian $32 · 10th to 90th $28 to $63
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 $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier None (both parts) Typical Low $30.20 Median $30.20 Typical High $53.70 | Professional | None (both parts) | $30.20 | $30.20 | $53.70 |
BCBS South Carolina Setting Facility Modifier None Typical Low $56.23 Median $63.10 Typical High $63.10 | Facility | None | $56.23 | $63.10 | $63.10 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $32.36 Median $47.86 Typical High $63.10 | Professional | None (both parts) | $32.36 | $47.86 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Facility | None | $33.88 | $33.88 | $36.31 |
Cigna Setting Professional Modifier None (both parts) Typical Low $25.12 Median $25.12 Typical High $37.15 | Professional | None (both parts) | $25.12 | $25.12 | $37.15 |
Medcost Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Medcost Setting Facility Modifier None Typical Low $17.78 Median $34.67 Typical High $75.86 | Facility | None | $17.78 | $34.67 | $75.86 |
Medcost Setting Professional Modifier None (both parts) Typical Low $36.31 Median $46.77 Typical High $81.28 | Professional | None (both parts) | $36.31 | $46.77 | $81.28 |
United Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
United Setting Professional Modifier None (both parts) Typical Low $20.89 Median $30.20 Typical High $37.15 | Professional | None (both parts) | $20.89 | $30.20 | $37.15 |
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 $15.14 Median $15.14 Typical High $18.62 | Professional | 52 · Reduced service | $15.14 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $7.41 | Professional | 53 · Discontinued | $6.17 | $6.17 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $5.50 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $3.72 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $18.20 Median $18.62 Typical High $43.65 | Professional | 26 · Professional part | $18.20 | $18.62 | $43.65 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $53.70 Median $70.79 Typical High $162.18 | Professional | 50 · Both sides | $53.70 | $70.79 | $162.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $18.20 Median $23.44 Typical High $54.95 | Professional | 51 · Multiple procedures | $18.20 | $23.44 | $54.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.24 Median $9.33 Typical High $21.88 | Professional | 80 · Assistant surgeon | $7.24 | $9.33 | $21.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.01 Median $6.61 Typical High $15.14 | Professional | 81 · Minimal assistant surgeon | $5.01 | $6.61 | $15.14 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.01 Median $6.61 Typical High $15.14 | Professional | 82 · Assistant surgeon, no resident | $5.01 | $6.61 | $15.14 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.01 Median $6.61 Typical High $15.14 | Professional | AS · PA/NP assist | $5.01 | $6.61 | $15.14 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $27.54 Median $28.18 Typical High $66.07 | Professional | TC · Technical part | $27.54 | $28.18 | $66.07 |
Where South Carolina sits
The same service costs 2.8 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· 41st of 51
$32.36
MT $64.57KS $23.44
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.