How much rates vary
Facilitymedian $23 · 10th to 90th $20 to $43Professionalmedian $22 · 10th to 90th $19 to $43
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 $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier None (both parts) Typical Low $20.42 Median $20.42 Typical High $25.12 | Professional | None (both parts) | $20.42 | $20.42 | $25.12 |
BCBS South Carolina Setting Facility Modifier None Typical Low $38.02 Median $42.66 Typical High $42.66 | Facility | None | $38.02 | $42.66 | $42.66 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $21.88 Median $33.11 Typical High $42.66 | Professional | None (both parts) | $21.88 | $33.11 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None (both parts) Typical Low $16.98 Median $16.98 Typical High $25.12 | Professional | None (both parts) | $16.98 | $16.98 | $25.12 |
Medcost Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Medcost Setting Facility Modifier None Typical Low $12.02 Median $22.91 Typical High $51.29 | Facility | None | $12.02 | $22.91 | $51.29 |
Medcost Setting Professional Modifier None (both parts) Typical Low $23.99 Median $32.36 Typical High $54.95 | Professional | None (both parts) | $23.99 | $32.36 | $54.95 |
Molina Setting Professional Modifier None (both parts) Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None (both parts) | $28.18 | $28.18 | $28.18 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier None (both parts) Typical Low $14.13 Median $20.42 Typical High $25.12 | Professional | None (both parts) | $14.13 | $20.42 | $25.12 |
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 $10.23 Median $10.23 Typical High $12.59 | Professional | 52 · Reduced service | $10.23 | $10.23 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $5.01 | Professional | 53 · Discontinued | $4.07 | $4.07 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.09 Typical High $3.72 | Professional | 55 · Aftercare only | $3.09 | $3.09 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.51 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $12.30 Median $12.88 Typical High $29.51 | Professional | 26 · Professional part | $12.30 | $12.88 | $29.51 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $36.31 Median $47.86 Typical High $109.65 | Professional | 50 · Both sides | $36.31 | $47.86 | $109.65 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.02 Median $15.85 Typical High $37.15 | Professional | 51 · Multiple procedures | $12.02 | $15.85 | $37.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.79 Median $6.46 Typical High $14.79 | Professional | 80 · Assistant surgeon | $4.79 | $6.46 | $14.79 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.39 Median $4.47 Typical High $10.23 | Professional | 81 · Minimal assistant surgeon | $3.39 | $4.47 | $10.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.39 Median $4.47 Typical High $10.23 | Professional | 82 · Assistant surgeon, no resident | $3.39 | $4.47 | $10.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.39 Median $4.47 Typical High $10.23 | Professional | AS · PA/NP assist | $3.39 | $4.47 | $10.23 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $18.62 Median $19.05 Typical High $44.67 | Professional | TC · Technical part | $18.62 | $19.05 | $44.67 |
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· 32nd of 51
$21.88
MT $43.65DE $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.