How much rates vary
Facilitymedian $27 · 10th to 90th $23 to $47Professionalmedian $24 · 10th to 90th $20 to $47
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 $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier None (both parts) Typical Low $22.91 Median $22.91 Typical High $27.54 | Professional | None (both parts) | $22.91 | $22.91 | $27.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $42.66 Median $46.77 Typical High $46.77 | Facility | None | $42.66 | $46.77 | $46.77 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $23.99 Median $34.67 Typical High $46.77 | Professional | None (both parts) | $23.99 | $34.67 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None (both parts) Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None (both parts) | $19.95 | $19.95 | $27.54 |
Medcost Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Medcost Setting Facility Modifier None Typical Low $13.18 Median $25.70 Typical High $57.54 | Facility | None | $13.18 | $25.70 | $57.54 |
Medcost Setting Professional Modifier None (both parts) Typical Low $26.92 Median $34.67 Typical High $61.66 | Professional | None (both parts) | $26.92 | $34.67 | $61.66 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
United Setting Professional Modifier None (both parts) Typical Low $15.85 Median $22.39 Typical High $27.54 | Professional | None (both parts) | $15.85 | $22.39 | $27.54 |
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 $11.48 Median $11.48 Typical High $13.80 | Professional | 52 · Reduced service | $11.48 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.57 Typical High $5.50 | Professional | 53 · Discontinued | $4.57 | $4.57 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.47 Typical High $4.17 | Professional | 55 · Aftercare only | $3.47 | $3.47 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.29 | $2.29 | $2.75 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $13.80 Median $14.13 Typical High $32.36 | Professional | 26 · Professional part | $13.80 | $14.13 | $32.36 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $40.74 Median $52.48 Typical High $123.03 | Professional | 50 · Both sides | $40.74 | $52.48 | $123.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $13.49 Median $17.38 Typical High $40.74 | Professional | 51 · Multiple procedures | $13.49 | $17.38 | $40.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.37 Median $7.08 Typical High $16.22 | Professional | 80 · Assistant surgeon | $5.37 | $7.08 | $16.22 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.80 Median $4.90 Typical High $11.48 | Professional | 81 · Minimal assistant surgeon | $3.80 | $4.90 | $11.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.80 Median $4.90 Typical High $11.48 | Professional | 82 · Assistant surgeon, no resident | $3.80 | $4.90 | $11.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.80 Median $4.90 Typical High $11.48 | Professional | AS · PA/NP assist | $3.80 | $4.90 | $11.48 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $20.42 Median $20.89 Typical High $48.98 | Professional | TC · Technical part | $20.42 | $20.89 | $48.98 |
Where South Carolina sits
The same service costs 2.5 times more in Montana 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· 32nd of 51
$24.55
MT $48.98DE $19.95
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.