How much rates vary
Facilitymedian $42 · 10th to 90th $37 to $78Professionalmedian $40 · 10th to 90th $34 to $78
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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None (both parts) Typical Low $37.15 Median $37.15 Typical High $45.71 | Professional | None (both parts) | $37.15 | $37.15 | $45.71 |
BCBS South Carolina Setting Facility Modifier None Typical Low $69.18 Median $77.62 Typical High $77.62 | Facility | None | $69.18 | $77.62 | $77.62 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $39.81 Median $57.54 Typical High $77.62 | Professional | None (both parts) | $39.81 | $57.54 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Professional Modifier None (both parts) Typical Low $30.90 Median $30.90 Typical High $45.71 | Professional | None (both parts) | $30.90 | $30.90 | $45.71 |
Medcost Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medcost Setting Facility Modifier None Typical Low $21.38 Median $41.69 Typical High $93.33 | Facility | None | $21.38 | $41.69 | $93.33 |
Medcost Setting Professional Modifier None (both parts) Typical Low $47.86 Median $57.54 Typical High $100.00 | Professional | None (both parts) | $47.86 | $57.54 | $100.00 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
United Setting Professional Modifier None (both parts) Typical Low $25.70 Median $37.15 Typical High $45.71 | Professional | None (both parts) | $25.70 | $37.15 | $45.71 |
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 $18.62 Median $18.62 Typical High $22.39 | Professional | 52 · Reduced service | $18.62 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $9.12 | Professional | 53 · Discontinued | $7.41 | $7.41 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $6.76 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $4.57 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $22.39 Median $22.91 Typical High $53.70 | Professional | 26 · Professional part | $22.39 | $22.91 | $53.70 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $72.44 Median $85.11 Typical High $199.53 | Professional | 50 · Both sides | $72.44 | $85.11 | $199.53 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $23.99 Median $28.18 Typical High $66.07 | Professional | 51 · Multiple procedures | $23.99 | $28.18 | $66.07 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.55 Median $11.48 Typical High $26.92 | Professional | 80 · Assistant surgeon | $9.55 | $11.48 | $26.92 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.76 Median $7.94 Typical High $18.62 | Professional | 81 · Minimal assistant surgeon | $6.76 | $7.94 | $18.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.76 Median $7.94 Typical High $18.62 | Professional | 82 · Assistant surgeon, no resident | $6.76 | $7.94 | $18.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.76 Median $7.94 Typical High $18.62 | Professional | AS · PA/NP assist | $6.76 | $7.94 | $18.62 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $33.88 Median $33.88 Typical High $79.43 | Professional | TC · Technical part | $33.88 | $33.88 | $79.43 |
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· 39th of 51
$39.81
MT $79.43DE $30.90
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.