How much rates vary
Facilitymedian $55 · 10th to 90th $38 to $78Professionalmedian $45 · 10th to 90th $38 to $78
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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None (both parts) Typical Low $38.02 Median $38.02 Typical High $46.77 | Professional | None (both parts) | $38.02 | $38.02 | $46.77 |
BCBS South Carolina Setting Facility Modifier None Typical Low $69.18 Median $77.62 Typical High $77.62 | Facility | None | $69.18 | $77.62 | $77.62 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $44.67 Median $64.57 Typical High $77.62 | Professional | None (both parts) | $44.67 | $64.57 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None (both parts) Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None (both parts) | $39.81 | $39.81 | $54.95 |
Medcost Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $46.77 | Professional | None | $38.90 | $38.90 | $46.77 |
Medcost Setting Facility Modifier None Typical Low $24.55 Median $45.71 Typical High $93.33 | Facility | None | $24.55 | $45.71 | $93.33 |
Medcost Setting Professional Modifier None (both parts) Typical Low $42.66 Median $54.95 Typical High $102.33 | Professional | None (both parts) | $42.66 | $54.95 | $102.33 |
United Setting Facility Modifier None Typical Low $51.29 Median $104.71 Typical High $104.71 | Facility | None | $51.29 | $104.71 | $104.71 |
United Setting Professional Modifier None (both parts) Typical Low $29.51 Median $38.02 Typical High $47.86 | Professional | None (both parts) | $29.51 | $38.02 | $47.86 |
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 $19.05 Median $19.05 Typical High $23.44 | Professional | 52 · Reduced service | $19.05 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $9.33 | Professional | 53 · Discontinued | $7.59 | $7.59 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $7.08 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $4.68 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $21.88 Median $22.91 Typical High $53.70 | Professional | 26 · Professional part | $21.88 | $22.91 | $53.70 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $64.57 Median $83.18 Typical High $204.17 | Professional | 50 · Both sides | $64.57 | $83.18 | $204.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $21.38 Median $27.54 Typical High $67.61 | Professional | 51 · Multiple procedures | $21.38 | $27.54 | $67.61 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.51 Median $10.96 Typical High $26.92 | Professional | 80 · Assistant surgeon | $8.51 | $10.96 | $26.92 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.03 Median $7.76 Typical High $19.05 | Professional | 81 · Minimal assistant surgeon | $6.03 | $7.76 | $19.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.03 Median $7.76 Typical High $19.05 | Professional | 82 · Assistant surgeon, no resident | $6.03 | $7.76 | $19.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.03 Median $7.76 Typical High $19.05 | Professional | AS · PA/NP assist | $6.03 | $7.76 | $19.05 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $33.11 Median $34.67 Typical High $81.28 | Professional | TC · Technical part | $33.11 | $34.67 | $81.28 |
Where South Carolina sits
The same service costs 3.5 times more in Hawaii than in West Virginia. 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· 42nd of 51
$44.67
HI $141WV $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.