How much rates vary
Facilitymedian $58 · 10th to 90th $56 to $162Professionalmedian $135 · 10th to 90th $56 to $182
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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $57.54 Median $57.54 Typical High $81.28 | Professional | None (both parts) | $57.54 | $57.54 | $81.28 |
BCBS South Carolina Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $134.90 Median $169.82 Typical High $186.21 | Professional | None (both parts) | $134.90 | $169.82 | $186.21 |
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 $41.69 Median $41.69 Typical High $56.23 | Professional | None (both parts) | $41.69 | $41.69 | $56.23 |
Medcost Setting Facility Modifier None Typical Low $57.54 Median $60.26 Typical High $93.33 | Facility | None | $57.54 | $60.26 | $93.33 |
Medcost Setting Professional Modifier None (both parts) Typical Low $112.20 Median $190.55 Typical High $245.47 | Professional | None (both parts) | $112.20 | $190.55 | $245.47 |
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 $46.77 Median $70.79 Typical High $117.49 | Professional | None (both parts) | $46.77 | $70.79 | $117.49 |
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 $28.84 Median $28.84 Typical High $40.74 | Professional | 52 · Reduced service | $28.84 | $28.84 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $16.22 | Professional | 53 · Discontinued | $11.48 | $11.48 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $12.30 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $8.13 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $45.71 Median $77.62 Typical High $97.72 | Professional | 26 · Professional part | $45.71 | $77.62 | $97.72 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $309.03 Typical High $363.08 | Professional | 50 · Both sides | $169.82 | $309.03 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $56.23 Median $102.33 Typical High $123.03 | Professional | 51 · Multiple procedures | $56.23 | $102.33 | $123.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.91 Median $40.74 Typical High $48.98 | Professional | 80 · Assistant surgeon | $22.91 | $40.74 | $48.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.85 Median $28.84 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $15.85 | $28.84 | $33.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.85 Median $28.84 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $15.85 | $28.84 | $33.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.85 Median $28.84 Typical High $33.88 | Professional | AS · PA/NP assist | $15.85 | $28.84 | $33.88 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $67.61 Median $117.49 Typical High $147.91 | Professional | TC · Technical part | $67.61 | $117.49 | $147.91 |
Where South Carolina sits
The same service costs 4.9 times more in North Dakota than in Delaware. 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· 13th of 51
$135
ND $295DE $60.26
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.