How much rates vary
Facilitymedian $44 · 10th to 90th $39 to $79Professionalmedian $41 · 10th to 90th $35 to $79
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 $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None (both parts) Typical Low $38.90 Median $38.90 Typical High $46.77 | Professional | None (both parts) | $38.90 | $38.90 | $46.77 |
BCBS South Carolina Setting Facility Modifier None Typical Low $72.44 Median $79.43 Typical High $79.43 | Facility | None | $72.44 | $79.43 | $79.43 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $40.74 Median $58.88 Typical High $79.43 | Professional | None (both parts) | $40.74 | $58.88 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None (both parts) Typical Low $31.62 Median $31.62 Typical High $46.77 | Professional | None (both parts) | $31.62 | $31.62 | $46.77 |
Medcost Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Medcost Setting Facility Modifier None Typical Low $22.39 Median $43.65 Typical High $97.72 | Facility | None | $22.39 | $43.65 | $97.72 |
Medcost Setting Professional Modifier None (both parts) Typical Low $44.67 Median $60.26 Typical High $104.71 | Professional | None (both parts) | $44.67 | $60.26 | $104.71 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None (both parts) Typical Low $26.92 Median $38.02 Typical High $46.77 | Professional | None (both parts) | $26.92 | $38.02 | $46.77 |
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 $19.50 Median $19.50 Typical High $23.44 | Professional | 52 · Reduced service | $19.50 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $9.33 | Professional | 53 · Discontinued | $7.76 | $7.76 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $7.08 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $4.68 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $23.44 Median $23.99 Typical High $56.23 | Professional | 26 · Professional part | $23.44 | $23.99 | $56.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $67.61 Median $89.13 Typical High $208.93 | Professional | 50 · Both sides | $67.61 | $89.13 | $208.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.39 Median $30.20 Typical High $69.18 | Professional | 51 · Multiple procedures | $22.39 | $30.20 | $69.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.91 Median $12.02 Typical High $27.54 | Professional | 80 · Assistant surgeon | $8.91 | $12.02 | $27.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.31 Median $8.32 Typical High $19.50 | Professional | 81 · Minimal assistant surgeon | $6.31 | $8.32 | $19.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.31 Median $8.32 Typical High $19.50 | Professional | 82 · Assistant surgeon, no resident | $6.31 | $8.32 | $19.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.31 Median $8.32 Typical High $19.50 | Professional | AS · PA/NP assist | $6.31 | $8.32 | $19.50 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $34.67 Median $36.31 Typical High $83.18 | Professional | TC · Technical part | $34.67 | $36.31 | $83.18 |
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· 37th of 51
$41.69
MT $83.18DE $31.62
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.