How much rates vary
Facilitymedian $107 · 10th to 90th $95 to $200Professionalmedian $100 · 10th to 90th $87 to $200
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 $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None (both parts) Typical Low $95.50 Median $95.50 Typical High $117.49 | Professional | None (both parts) | $95.50 | $95.50 | $117.49 |
BCBS South Carolina Setting Facility Modifier None Typical Low $177.83 Median $199.53 Typical High $199.53 | Facility | None | $177.83 | $199.53 | $199.53 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $100.00 Median $144.54 Typical High $199.53 | Professional | None (both parts) | $100.00 | $144.54 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None (both parts) Typical Low $79.43 Median $79.43 Typical High $117.49 | Professional | None (both parts) | $79.43 | $79.43 | $117.49 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $54.95 Median $107.15 Typical High $239.88 | Facility | None | $54.95 | $107.15 | $239.88 |
Medcost Setting Professional Modifier None (both parts) Typical Low $112.20 Median $147.91 Typical High $257.04 | Professional | None (both parts) | $112.20 | $147.91 | $257.04 |
Molina Setting Professional Modifier None (both parts) Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None (both parts) | $131.83 | $131.83 | $131.83 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
United Setting Professional Modifier None (both parts) Typical Low $66.07 Median $95.50 Typical High $117.49 | Professional | None (both parts) | $66.07 | $95.50 | $117.49 |
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 $47.86 Median $47.86 Typical High $58.88 | Professional | 52 · Reduced service | $47.86 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $23.44 | Professional | 53 · Discontinued | $19.05 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $17.38 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $11.75 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $57.54 Median $58.88 Typical High $138.04 | Professional | 26 · Professional part | $57.54 | $58.88 | $138.04 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $218.78 Typical High $512.86 | Professional | 50 · Both sides | $169.82 | $218.78 | $512.86 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $56.23 Median $74.13 Typical High $173.78 | Professional | 51 · Multiple procedures | $56.23 | $74.13 | $173.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.39 Median $29.51 Typical High $69.18 | Professional | 80 · Assistant surgeon | $22.39 | $29.51 | $69.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.85 Median $20.42 Typical High $47.86 | Professional | 81 · Minimal assistant surgeon | $15.85 | $20.42 | $47.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.85 Median $20.42 Typical High $47.86 | Professional | 82 · Assistant surgeon, no resident | $15.85 | $20.42 | $47.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.85 Median $20.42 Typical High $47.86 | Professional | AS · PA/NP assist | $15.85 | $20.42 | $47.86 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $87.10 Median $89.13 Typical High $204.17 | Professional | TC · Technical part | $87.10 | $89.13 | $204.17 |
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· 29th of 51
$102
MT $204DE $79.43
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.