How much rates vary
Facilitymedian $56 · 10th to 90th $33 to $68Professionalmedian $40 · 10th to 90th $33 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 $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None (both parts) Typical Low $33.11 Median $33.11 Typical High $40.74 | Professional | None (both parts) | $33.11 | $33.11 | $40.74 |
BCBS South Carolina Setting Facility Modifier None Typical Low $60.26 Median $67.61 Typical High $67.61 | Facility | None | $60.26 | $67.61 | $67.61 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $39.81 Median $57.54 Typical High $67.61 | Professional | None (both parts) | $39.81 | $57.54 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None (both parts) Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None (both parts) | $40.74 | $40.74 | $56.23 |
Medcost Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $44.67 | Professional | None | $33.11 | $33.11 | $44.67 |
Medcost Setting Facility Modifier None Typical Low $21.38 Median $38.90 Typical High $81.28 | Facility | None | $21.38 | $38.90 | $81.28 |
Medcost Setting Professional Modifier None (both parts) Typical Low $37.15 Median $47.86 Typical High $89.13 | Professional | None (both parts) | $37.15 | $47.86 | $89.13 |
United Setting Facility Modifier None Typical Low $43.65 Median $89.13 Typical High $89.13 | Facility | None | $43.65 | $89.13 | $89.13 |
United Setting Professional Modifier None (both parts) Typical Low $25.70 Median $33.11 Typical High $41.69 | Professional | None (both parts) | $25.70 | $33.11 | $41.69 |
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 $16.22 Median $16.22 Typical High $20.42 | Professional | 52 · Reduced service | $16.22 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $8.13 | Professional | 53 · Discontinued | $6.61 | $6.61 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $6.17 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $4.07 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $19.05 Median $19.95 Typical High $46.77 | Professional | 26 · Professional part | $19.05 | $19.95 | $46.77 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $54.95 Median $72.44 Typical High $177.83 | Professional | 50 · Both sides | $54.95 | $72.44 | $177.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $18.62 Median $23.99 Typical High $58.88 | Professional | 51 · Multiple procedures | $18.62 | $23.99 | $58.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.41 Median $9.55 Typical High $23.44 | Professional | 80 · Assistant surgeon | $7.41 | $9.55 | $23.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.13 Median $6.76 Typical High $16.60 | Professional | 81 · Minimal assistant surgeon | $5.13 | $6.76 | $16.60 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.13 Median $6.76 Typical High $16.60 | Professional | 82 · Assistant surgeon, no resident | $5.13 | $6.76 | $16.60 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.13 Median $6.76 Typical High $16.60 | Professional | AS · PA/NP assist | $5.13 | $6.76 | $16.60 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $28.84 Median $30.20 Typical High $70.79 | Professional | TC · Technical part | $28.84 | $30.20 | $70.79 |
Where South Carolina sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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· 50th of 51
$39.81
HI $123KY $39.81
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.