How much rates vary
Facilitymedian $33 · 10th to 90th $30 to $62Professionalmedian $32 · 10th to 90th $27 to $62
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 $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier None (both parts) Typical Low $29.51 Median $29.51 Typical High $36.31 | Professional | None (both parts) | $29.51 | $29.51 | $36.31 |
BCBS South Carolina Setting Facility Modifier None Typical Low $54.95 Median $61.66 Typical High $61.66 | Facility | None | $54.95 | $61.66 | $61.66 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $32.36 Median $45.71 Typical High $61.66 | Professional | None (both parts) | $32.36 | $45.71 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $24.55 Median $24.55 Typical High $36.31 | Professional | None (both parts) | $24.55 | $24.55 | $36.31 |
Medcost Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Medcost Setting Facility Modifier None Typical Low $17.38 Median $33.11 Typical High $74.13 | Facility | None | $17.38 | $33.11 | $74.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $38.02 Median $45.71 Typical High $79.43 | Professional | None (both parts) | $38.02 | $45.71 | $79.43 |
Molina Setting Professional Modifier None (both parts) Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None (both parts) | $40.74 | $40.74 | $40.74 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None (both parts) Typical Low $20.42 Median $29.51 Typical High $36.31 | Professional | None (both parts) | $20.42 | $29.51 | $36.31 |
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 $14.79 Median $14.79 Typical High $18.20 | Professional | 52 · Reduced service | $14.79 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $7.24 | Professional | 53 · Discontinued | $5.89 | $5.89 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $5.37 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $3.63 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $17.78 Median $18.20 Typical High $42.66 | Professional | 26 · Professional part | $17.78 | $18.20 | $42.66 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $57.54 Median $69.18 Typical High $158.49 | Professional | 50 · Both sides | $57.54 | $69.18 | $158.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.05 Median $22.91 Typical High $53.70 | Professional | 51 · Multiple procedures | $19.05 | $22.91 | $53.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.59 Median $9.12 Typical High $21.38 | Professional | 80 · Assistant surgeon | $7.59 | $9.12 | $21.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.37 Median $6.46 Typical High $14.79 | Professional | 81 · Minimal assistant surgeon | $5.37 | $6.46 | $14.79 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.37 Median $6.46 Typical High $14.79 | Professional | 82 · Assistant surgeon, no resident | $5.37 | $6.46 | $14.79 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.37 Median $6.46 Typical High $14.79 | Professional | AS · PA/NP assist | $5.37 | $6.46 | $14.79 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $26.92 Median $27.54 Typical High $64.57 | Professional | TC · Technical part | $26.92 | $27.54 | $64.57 |
Where South Carolina sits
The same service costs 2.6 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· 30th of 51
$32.36
MT $63.10DE $24.55
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.