How much rates vary
Facilitymedian $51 · 10th to 90th $46 to $93Professionalmedian $48 · 10th to 90th $41 to $93
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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None (both parts) Typical Low $45.71 Median $45.71 Typical High $54.95 | Professional | None (both parts) | $45.71 | $45.71 | $54.95 |
BCBS South Carolina Setting Facility Modifier None Typical Low $85.11 Median $93.33 Typical High $93.33 | Facility | None | $85.11 | $93.33 | $93.33 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $47.86 Median $69.18 Typical High $93.33 | Professional | None (both parts) | $47.86 | $69.18 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None (both parts) Typical Low $37.15 Median $37.15 Typical High $54.95 | Professional | None (both parts) | $37.15 | $37.15 | $54.95 |
Medcost Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Medcost Setting Facility Modifier None Typical Low $26.30 Median $51.29 Typical High $114.82 | Facility | None | $26.30 | $51.29 | $114.82 |
Medcost Setting Professional Modifier None (both parts) Typical Low $57.54 Median $70.79 Typical High $123.03 | Professional | None (both parts) | $57.54 | $70.79 | $123.03 |
Molina Setting Professional Modifier None (both parts) Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None (both parts) | $63.10 | $63.10 | $63.10 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
United Setting Professional Modifier None (both parts) Typical Low $31.62 Median $44.67 Typical High $54.95 | Professional | None (both parts) | $31.62 | $44.67 | $54.95 |
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 $22.91 Median $22.91 Typical High $27.54 | Professional | 52 · Reduced service | $22.91 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $10.96 | Professional | 53 · Discontinued | $9.12 | $9.12 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $8.32 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $5.50 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $27.54 Median $28.18 Typical High $66.07 | Professional | 26 · Professional part | $27.54 | $28.18 | $66.07 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $87.10 Median $104.71 Typical High $245.47 | Professional | 50 · Both sides | $87.10 | $104.71 | $245.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $28.84 Median $34.67 Typical High $81.28 | Professional | 51 · Multiple procedures | $28.84 | $34.67 | $81.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.48 Median $14.13 Typical High $33.11 | Professional | 80 · Assistant surgeon | $11.48 | $14.13 | $33.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.13 Median $9.77 Typical High $22.91 | Professional | 81 · Minimal assistant surgeon | $8.13 | $9.77 | $22.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.13 Median $9.77 Typical High $22.91 | Professional | 82 · Assistant surgeon, no resident | $8.13 | $9.77 | $22.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.13 Median $9.77 Typical High $22.91 | Professional | AS · PA/NP assist | $8.13 | $9.77 | $22.91 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $40.74 Median $41.69 Typical High $97.72 | Professional | TC · Technical part | $40.74 | $41.69 | $97.72 |
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· 33rd of 51
$48.98
MT $97.72DE $37.15
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.