How much rates vary
Facilitymedian $50 · 10th to 90th $25 to $68Professionalmedian $51 · 10th to 90th $25 to $68
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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None (both parts) Typical Low $24.55 Median $24.55 Typical High $34.67 | Professional | None (both parts) | $24.55 | $24.55 | $34.67 |
BCBS South Carolina Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $42.66 Median $52.48 Typical High $67.61 | Professional | None (both parts) | $42.66 | $52.48 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None (both parts) Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None (both parts) | $36.31 | $36.31 | $50.12 |
Medcost Setting Facility Modifier None Typical Low $24.55 Median $25.12 Typical High $39.81 | Facility | None | $24.55 | $25.12 | $39.81 |
Medcost Setting Professional Modifier None (both parts) Typical Low $47.86 Median $58.88 Typical High $72.44 | Professional | None (both parts) | $47.86 | $58.88 | $72.44 |
Molina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $43.65 Typical High $43.65 | Professional | None (both parts) | $30.20 | $43.65 | $43.65 |
United Setting Professional Modifier None (both parts) Typical Low $19.95 Median $30.20 Typical High $48.98 | Professional | None (both parts) | $19.95 | $30.20 | $48.98 |
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 $12.02 Median $12.02 Typical High $17.38 | Professional | 52 · Reduced service | $12.02 | $12.02 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $6.92 | Professional | 53 · Discontinued | $4.90 | $4.90 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $5.13 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $3.47 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $19.05 Median $23.44 Typical High $34.67 | Professional | 26 · Professional part | $19.05 | $23.44 | $34.67 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $70.79 Median $89.13 Typical High $131.83 | Professional | 50 · Both sides | $70.79 | $89.13 | $131.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $23.99 Median $29.51 Typical High $43.65 | Professional | 51 · Multiple procedures | $23.99 | $29.51 | $43.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.55 Median $11.75 Typical High $17.38 | Professional | 80 · Assistant surgeon | $9.55 | $11.75 | $17.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.61 Median $8.32 Typical High $12.30 | Professional | 81 · Minimal assistant surgeon | $6.61 | $8.32 | $12.30 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.61 Median $8.32 Typical High $12.30 | Professional | 82 · Assistant surgeon, no resident | $6.61 | $8.32 | $12.30 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.61 Median $8.32 Typical High $12.30 | Professional | AS · PA/NP assist | $6.61 | $8.32 | $12.30 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $28.84 Median $35.48 Typical High $52.48 | Professional | TC · Technical part | $28.84 | $35.48 | $52.48 |
Where South Carolina sits
The same service costs 4.1 times more in Kansas 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· 15th of 51
$50.12
KS $135CO $33.11
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.