How much rates vary
Facilitymedian $40 · 10th to 90th $14 to $55Professionalmedian $41 · 10th to 90th $14 to $89
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 $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier None (both parts) Typical Low $14.45 Median $14.45 Typical High $20.42 | Professional | None (both parts) | $14.45 | $14.45 | $20.42 |
BCBS South Carolina Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $40.74 Median $89.13 Typical High $100.00 | Professional | None (both parts) | $40.74 | $89.13 | $100.00 |
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 Facility Modifier None Typical Low $14.45 Median $15.14 Typical High $23.44 | Facility | None | $14.45 | $15.14 | $23.44 |
Medcost Setting Professional Modifier None (both parts) Typical Low $28.18 Median $34.67 Typical High $45.71 | Professional | None (both parts) | $28.18 | $34.67 | $45.71 |
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 $11.75 Median $17.78 Typical High $29.51 | Professional | None (both parts) | $11.75 | $17.78 | $29.51 |
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 $7.24 Median $7.24 Typical High $10.23 | Professional | 52 · Reduced service | $7.24 | $7.24 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $4.07 | Professional | 53 · Discontinued | $2.88 | $2.88 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $3.09 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $2.04 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $11.48 Median $16.22 Typical High $26.30 | Professional | 26 · Professional part | $11.48 | $16.22 | $26.30 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $42.66 Median $52.48 Typical High $93.33 | Professional | 50 · Both sides | $42.66 | $52.48 | $93.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.13 Median $17.38 Typical High $30.90 | Professional | 51 · Multiple procedures | $14.13 | $17.38 | $30.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.75 Median $7.08 Typical High $12.30 | Professional | 80 · Assistant surgeon | $5.75 | $7.08 | $12.30 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.98 Median $4.90 Typical High $8.71 | Professional | 81 · Minimal assistant surgeon | $3.98 | $4.90 | $8.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.98 Median $4.90 Typical High $8.71 | Professional | 82 · Assistant surgeon, no resident | $3.98 | $4.90 | $8.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.98 Median $4.90 Typical High $8.71 | Professional | AS · PA/NP assist | $3.98 | $4.90 | $8.71 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $16.98 Median $23.99 Typical High $39.81 | Professional | TC · Technical part | $16.98 | $23.99 | $39.81 |
Where South Carolina sits
The same service costs 8.9 times more in North Dakota 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
$40.74
ND $174CO $19.50
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.