How much rates vary
Facilitymedian $25 · 10th to 90th $17 to $36Professionalmedian $19 · 10th to 90th $17 to $36
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 $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier None (both parts) Typical Low $17.38 Median $17.38 Typical High $21.38 | Professional | None (both parts) | $17.38 | $17.38 | $21.38 |
BCBS South Carolina Setting Facility Modifier None Typical Low $32.36 Median $36.31 Typical High $36.31 | Facility | None | $32.36 | $36.31 | $36.31 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $19.05 Median $27.54 Typical High $36.31 | Professional | None (both parts) | $19.05 | $27.54 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None (both parts) Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None (both parts) | $17.78 | $17.78 | $24.55 |
Medcost Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Medcost Setting Facility Modifier None Typical Low $10.23 Median $19.50 Typical High $43.65 | Facility | None | $10.23 | $19.50 | $43.65 |
Medcost Setting Professional Modifier None (both parts) Typical Low $21.88 Median $26.92 Typical High $46.77 | Professional | None (both parts) | $21.88 | $26.92 | $46.77 |
Molina Setting Professional Modifier None (both parts) Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None (both parts) | $23.99 | $23.99 | $23.99 |
United Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
United Setting Professional Modifier None (both parts) Typical Low $12.02 Median $17.38 Typical High $21.38 | Professional | None (both parts) | $12.02 | $17.38 | $21.38 |
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 $8.71 Median $8.71 Typical High $10.72 | Professional | 52 · Reduced service | $8.71 | $8.71 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.55 Typical High $4.27 | Professional | 53 · Discontinued | $3.55 | $3.55 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $2.63 Typical High $3.16 | Professional | 55 · Aftercare only | $2.63 | $2.63 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.78 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.78 | $1.78 | $2.14 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $10.72 Median $10.72 Typical High $25.12 | Professional | 26 · Professional part | $10.72 | $10.72 | $25.12 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $33.11 Median $40.74 Typical High $93.33 | Professional | 50 · Both sides | $33.11 | $40.74 | $93.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $10.96 Median $13.49 Typical High $31.62 | Professional | 51 · Multiple procedures | $10.96 | $13.49 | $31.62 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.37 Median $5.37 Typical High $12.59 | Professional | 80 · Assistant surgeon | $4.37 | $5.37 | $12.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.09 Median $3.80 Typical High $8.71 | Professional | 81 · Minimal assistant surgeon | $3.09 | $3.80 | $8.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.09 Median $3.80 Typical High $8.71 | Professional | 82 · Assistant surgeon, no resident | $3.09 | $3.80 | $8.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.09 Median $3.80 Typical High $8.71 | Professional | AS · PA/NP assist | $3.09 | $3.80 | $8.71 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $15.85 Median $16.22 Typical High $38.02 | Professional | TC · Technical part | $15.85 | $16.22 | $38.02 |
Where South Carolina sits
The same service costs 2.1 times more in Montana than in West Virginia. 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· 35th of 51
$19.05
MT $37.15WV $17.78
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.