How much rates vary
Facilitymedian $39 · 10th to 90th $38 to $110Professionalmedian $60 · 10th to 90th $38 to $100
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 $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None (both parts) Typical Low $38.90 Median $38.90 Typical High $54.95 | Professional | None (both parts) | $38.90 | $38.90 | $54.95 |
BCBS South Carolina Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $47.86 Median $60.26 Typical High $109.65 | Professional | None (both parts) | $47.86 | $60.26 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $41.69 | Facility | None | $38.02 | $38.02 | $41.69 |
Cigna Setting Professional Modifier None (both parts) Typical Low $27.54 Median $27.54 Typical High $38.02 | Professional | None (both parts) | $27.54 | $27.54 | $38.02 |
Medcost Setting Facility Modifier None Typical Low $38.90 Median $40.74 Typical High $63.10 | Facility | None | $38.90 | $40.74 | $63.10 |
Medcost Setting Professional Modifier None (both parts) Typical Low $60.26 Median $79.43 Typical High $114.82 | Professional | None (both parts) | $60.26 | $79.43 | $114.82 |
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 $31.62 Median $47.86 Typical High $79.43 | Professional | None (both parts) | $31.62 | $47.86 | $79.43 |
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 $19.50 Median $19.50 Typical High $27.54 | Professional | 52 · Reduced service | $19.50 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $10.96 | Professional | 53 · Discontinued | $7.76 | $7.76 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $8.32 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $5.50 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $30.20 Median $31.62 Typical High $56.23 | Professional | 26 · Professional part | $30.20 | $31.62 | $56.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $89.13 Median $117.49 Typical High $208.93 | Professional | 50 · Both sides | $89.13 | $117.49 | $208.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.20 Median $39.81 Typical High $69.18 | Professional | 51 · Multiple procedures | $30.20 | $39.81 | $69.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.02 Median $15.85 Typical High $28.18 | Professional | 80 · Assistant surgeon | $12.02 | $15.85 | $28.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.32 Median $10.96 Typical High $19.50 | Professional | 81 · Minimal assistant surgeon | $8.32 | $10.96 | $19.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.32 Median $10.96 Typical High $19.50 | Professional | 82 · Assistant surgeon, no resident | $8.32 | $10.96 | $19.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.32 Median $10.96 Typical High $19.50 | Professional | AS · PA/NP assist | $8.32 | $10.96 | $19.50 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $44.67 Median $47.86 Typical High $83.18 | Professional | TC · Technical part | $44.67 | $47.86 | $83.18 |
Where South Carolina sits
The same service costs 49.0 times more in North Dakota than in Hawaii. 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· 18th of 51
$60.26
ND $120HI $2.45
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.