How much rates vary
Facilitymedian $34 · 10th to 90th $25 to $51Professionalmedian $27 · 10th to 90th $24 to $51
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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None (both parts) Typical Low $25.12 Median $25.12 Typical High $30.20 | Professional | None (both parts) | $25.12 | $25.12 | $30.20 |
BCBS South Carolina Setting Facility Modifier None Typical Low $46.77 Median $51.29 Typical High $51.29 | Facility | None | $46.77 | $51.29 | $51.29 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $26.92 Median $38.90 Typical High $51.29 | Professional | None (both parts) | $26.92 | $38.90 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None (both parts) Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None (both parts) | $24.55 | $24.55 | $33.88 |
Medcost Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Medcost Setting Facility Modifier None Typical Low $14.45 Median $28.18 Typical High $63.10 | Facility | None | $14.45 | $28.18 | $63.10 |
Medcost Setting Professional Modifier None (both parts) Typical Low $32.36 Median $38.90 Typical High $67.61 | Professional | None (both parts) | $32.36 | $38.90 | $67.61 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
United Setting Professional Modifier None (both parts) Typical Low $17.38 Median $24.55 Typical High $30.90 | Professional | None (both parts) | $17.38 | $24.55 | $30.90 |
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 $12.59 Median $12.59 Typical High $15.14 | Professional | 52 · Reduced service | $12.59 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $6.17 | Professional | 53 · Discontinued | $5.01 | $5.01 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $4.57 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $3.02 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $15.14 Median $15.49 Typical High $36.31 | Professional | 26 · Professional part | $15.14 | $15.49 | $36.31 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $47.86 Median $58.88 Typical High $134.90 | Professional | 50 · Both sides | $47.86 | $58.88 | $134.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.85 Median $19.50 Typical High $44.67 | Professional | 51 · Multiple procedures | $15.85 | $19.50 | $44.67 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.46 Median $7.76 Typical High $18.20 | Professional | 80 · Assistant surgeon | $6.46 | $7.76 | $18.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.47 Median $5.50 Typical High $12.59 | Professional | 81 · Minimal assistant surgeon | $4.47 | $5.50 | $12.59 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.47 Median $5.50 Typical High $12.59 | Professional | 82 · Assistant surgeon, no resident | $4.47 | $5.50 | $12.59 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.47 Median $5.50 Typical High $12.59 | Professional | AS · PA/NP assist | $4.47 | $5.50 | $12.59 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $22.39 Median $23.44 Typical High $53.70 | Professional | TC · Technical part | $22.39 | $23.44 | $53.70 |
Where South Carolina sits
The same service costs 2.2 times more in Montana than in Arizona. 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
$26.92
MT $53.70AZ $24.55
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.