How much rates vary
Facilitymedian $28 · 10th to 90th $13 to $35Professionalmedian $18 · 10th to 90th $13 to $32
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 $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier None (both parts) Typical Low $12.88 Median $12.88 Typical High $18.20 | Professional | None (both parts) | $12.88 | $12.88 | $18.20 |
BCBS South Carolina Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $14.45 Median $18.20 Typical High $35.48 | Professional | None (both parts) | $14.45 | $18.20 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None (both parts) | $19.95 | $19.95 | $27.54 |
Medcost Setting Facility Modifier None Typical Low $12.88 Median $13.18 Typical High $20.89 | Facility | None | $12.88 | $13.18 | $20.89 |
Medcost Setting Professional Modifier None (both parts) Typical Low $25.12 Median $30.90 Typical High $37.15 | Professional | None (both parts) | $25.12 | $30.90 | $37.15 |
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 $10.47 Median $15.85 Typical High $25.70 | Professional | None (both parts) | $10.47 | $15.85 | $25.70 |
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 $6.46 Median $6.46 Typical High $9.12 | Professional | 52 · Reduced service | $6.46 | $6.46 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.57 Typical High $3.63 | Professional | 53 · Discontinued | $2.57 | $2.57 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $1.91 Typical High $2.69 | Professional | 55 · Aftercare only | $1.91 | $1.91 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.82 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $10.00 Median $12.30 Typical High $18.20 | Professional | 26 · Professional part | $10.00 | $12.30 | $18.20 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $38.02 Median $46.77 Typical High $69.18 | Professional | 50 · Both sides | $38.02 | $46.77 | $69.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.59 Median $15.49 Typical High $22.91 | Professional | 51 · Multiple procedures | $12.59 | $15.49 | $22.91 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.01 Median $6.17 Typical High $9.12 | Professional | 80 · Assistant surgeon | $5.01 | $6.17 | $9.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.55 Median $4.37 Typical High $6.46 | Professional | 81 · Minimal assistant surgeon | $3.55 | $4.37 | $6.46 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.55 Median $4.37 Typical High $6.46 | Professional | 82 · Assistant surgeon, no resident | $3.55 | $4.37 | $6.46 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.55 Median $4.37 Typical High $6.46 | Professional | AS · PA/NP assist | $3.55 | $4.37 | $6.46 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $15.14 Median $18.62 Typical High $27.54 | Professional | TC · Technical part | $15.14 | $18.62 | $27.54 |
Where South Carolina sits
The same service costs 4.4 times more in Wyoming than in Colorado. 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· 49th of 51
$18.20
WY $75.86CO $17.38
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.