How much rates vary
Facilitymedian $34 · 10th to 90th $25 to $50Professionalmedian $26 · 10th to 90th $23 to $50
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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None (both parts) Typical Low $24.55 Median $24.55 Typical High $29.51 | Professional | None (both parts) | $24.55 | $24.55 | $29.51 |
BCBS South Carolina Setting Facility Modifier None Typical Low $45.71 Median $50.12 Typical High $50.12 | Facility | None | $45.71 | $50.12 | $50.12 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $25.70 Median $37.15 Typical High $50.12 | Professional | None (both parts) | $25.70 | $37.15 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None (both parts) Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None (both parts) | $24.55 | $24.55 | $33.88 |
Medcost Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Medcost Setting Facility Modifier None Typical Low $14.13 Median $27.54 Typical High $60.26 | Facility | None | $14.13 | $27.54 | $60.26 |
Medcost Setting Professional Modifier None (both parts) Typical Low $28.18 Median $38.02 Typical High $66.07 | Professional | None (both parts) | $28.18 | $38.02 | $66.07 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None (both parts) Typical Low $16.98 Median $23.99 Typical High $29.51 | Professional | None (both parts) | $16.98 | $23.99 | $29.51 |
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 $12.30 Median $12.30 Typical High $14.79 | Professional | 52 · Reduced service | $12.30 | $12.30 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $5.89 | Professional | 53 · Discontinued | $4.90 | $4.90 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $4.47 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.95 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $14.79 Median $15.14 Typical High $34.67 | Professional | 26 · Professional part | $14.79 | $15.14 | $34.67 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $41.69 Median $57.54 Typical High $131.83 | Professional | 50 · Both sides | $41.69 | $57.54 | $131.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.13 Median $19.05 Typical High $43.65 | Professional | 51 · Multiple procedures | $14.13 | $19.05 | $43.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.62 Median $7.59 Typical High $17.38 | Professional | 80 · Assistant surgeon | $5.62 | $7.59 | $17.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.89 Median $5.37 Typical High $12.30 | Professional | 81 · Minimal assistant surgeon | $3.89 | $5.37 | $12.30 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.89 Median $5.37 Typical High $12.30 | Professional | 82 · Assistant surgeon, no resident | $3.89 | $5.37 | $12.30 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.89 Median $5.37 Typical High $12.30 | Professional | AS · PA/NP assist | $3.89 | $5.37 | $12.30 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $21.88 Median $22.91 Typical High $52.48 | Professional | TC · Technical part | $21.88 | $22.91 | $52.48 |
Where South Carolina sits
The same service costs 3.1 times more in Montana 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· 39th of 51
$25.70
MT $52.48KS $16.98
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.