How much rates vary
Facilitymedian $28 · 10th to 90th $10 to $30Professionalmedian $30 · 10th to 90th $10 to $191
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 $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier None (both parts) Typical Low $10.47 Median $10.47 Typical High $14.79 | Professional | None (both parts) | $10.47 | $10.47 | $14.79 |
BCBS South Carolina Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $29.51 Median $190.55 Typical High $208.93 | Professional | None (both parts) | $29.51 | $190.55 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Professional Modifier None (both parts) Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | None (both parts) | $20.42 | $20.42 | $28.18 |
Medcost Setting Facility Modifier None Typical Low $10.47 Median $10.72 Typical High $16.98 | Facility | None | $10.47 | $10.72 | $16.98 |
Medcost Setting Professional Modifier None (both parts) Typical Low $12.02 Median $20.89 Typical High $30.90 | Professional | None (both parts) | $12.02 | $20.89 | $30.90 |
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 $8.51 Median $12.88 Typical High $20.89 | Professional | None (both parts) | $8.51 | $12.88 | $20.89 |
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 $5.25 Median $5.25 Typical High $7.41 | Professional | 52 · Reduced service | $5.25 | $5.25 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.09 Typical High $2.95 | Professional | 53 · Discontinued | $2.09 | $2.09 | $2.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.55 Median $1.55 Typical High $2.19 | Professional | 55 · Aftercare only | $1.55 | $1.55 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.05 Typical High $1.48 | Professional | 56 · Pre-op care only | $1.05 | $1.05 | $1.48 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $6.03 Median $10.00 Typical High $14.79 | Professional | 26 · Professional part | $6.03 | $10.00 | $14.79 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $18.20 Median $37.15 Typical High $56.23 | Professional | 50 · Both sides | $18.20 | $37.15 | $56.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.03 Median $12.30 Typical High $18.62 | Professional | 51 · Multiple procedures | $6.03 | $12.30 | $18.62 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.40 Median $5.01 Typical High $7.41 | Professional | 80 · Assistant surgeon | $2.40 | $5.01 | $7.41 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.70 Median $3.47 Typical High $5.25 | Professional | 81 · Minimal assistant surgeon | $1.70 | $3.47 | $5.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.70 Median $3.47 Typical High $5.25 | Professional | 82 · Assistant surgeon, no resident | $1.70 | $3.47 | $5.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.70 Median $3.47 Typical High $5.25 | Professional | AS · PA/NP assist | $1.70 | $3.47 | $5.25 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $9.12 Median $14.79 Typical High $22.39 | Professional | TC · Technical part | $9.12 | $14.79 | $22.39 |
Where South Carolina sits
The same service costs 8.7 times more in Hawaii than in Kansas. 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· 11th of 51
$29.51
HI $85.11KS $9.77
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.