How much rates vary
Facilitymedian $17 · 10th to 90th $6 to $21Professionalmedian $21 · 10th to 90th $6 to $35
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 $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier None (both parts) Typical Low $5.89 Median $5.89 Typical High $11.75 | Professional | None (both parts) | $5.89 | $5.89 | $11.75 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $7.41 Median $9.77 Typical High $20.89 | Professional | None (both parts) | $7.41 | $9.77 | $20.89 |
BCBS South Carolina Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $16.60 Median $34.67 Typical High $38.90 | Professional | None (both parts) | $16.60 | $34.67 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Facility | None | $20.89 | $20.89 | $21.38 |
Cigna Setting Professional Modifier None (both parts) Typical Low $15.49 Median $15.49 Typical High $20.89 | Professional | None (both parts) | $15.49 | $15.49 | $20.89 |
Medcost Setting Facility Modifier None Typical Low $5.89 Median $6.17 Typical High $9.55 | Facility | None | $5.89 | $6.17 | $9.55 |
Medcost Setting Professional Modifier None (both parts) Typical Low $11.48 Median $19.50 Typical High $30.90 | Professional | None (both parts) | $11.48 | $19.50 | $30.90 |
Molina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $30.20 Typical High $33.11 | Professional | None (both parts) | $30.20 | $30.20 | $33.11 |
United Setting Professional Modifier None (both parts) Typical Low $4.79 Median $7.24 Typical High $11.75 | Professional | None (both parts) | $4.79 | $7.24 | $11.75 |
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 $2.95 Median $2.95 Typical High $4.17 | Professional | 52 · Reduced service | $2.95 | $2.95 | $4.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.17 Median $1.17 Typical High $1.66 | Professional | 53 · Discontinued | $1.17 | $1.17 | $1.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.89 Median $0.89 Typical High $1.26 | Professional | 55 · Aftercare only | $0.89 | $0.89 | $1.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.59 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.59 | $0.59 | $0.83 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $4.57 Median $7.94 Typical High $11.48 | Professional | 26 · Professional part | $4.57 | $7.94 | $11.48 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $16.98 Median $34.67 Typical High $46.77 | Professional | 50 · Both sides | $16.98 | $34.67 | $46.77 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.75 Median $11.48 Typical High $15.49 | Professional | 51 · Multiple procedures | $5.75 | $11.48 | $15.49 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.29 Median $4.57 Typical High $6.17 | Professional | 80 · Assistant surgeon | $2.29 | $4.57 | $6.17 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.58 Median $3.24 Typical High $4.37 | Professional | 81 · Minimal assistant surgeon | $1.58 | $3.24 | $4.37 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.58 Median $3.24 Typical High $4.37 | Professional | 82 · Assistant surgeon, no resident | $1.58 | $3.24 | $4.37 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.58 Median $3.24 Typical High $4.37 | Professional | AS · PA/NP assist | $1.58 | $3.24 | $4.37 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $6.92 Median $12.02 Typical High $17.38 | Professional | TC · Technical part | $6.92 | $12.02 | $17.38 |
Where South Carolina sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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· 3rd of 51
$20.89
WY $53.70NC $8.71
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.