How much rates vary
Facilitymedian $46 · 10th to 90th $32 to $68Professionalmedian $40 · 10th to 90th $32 to $68
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 $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier None (both parts) Typical Low $32.36 Median $32.36 Typical High $57.54 | Professional | None (both parts) | $32.36 | $32.36 | $57.54 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $43.65 Median $57.54 Typical High $70.79 | Professional | None (both parts) | $43.65 | $57.54 | $70.79 |
BCBS South Carolina Setting Facility Modifier None Typical Low $13.49 Median $64.57 Typical High $67.61 | Facility | None | $13.49 | $64.57 | $67.61 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $39.81 Median $57.54 Typical High $67.61 | Professional | None (both parts) | $39.81 | $57.54 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None (both parts) Typical Low $33.11 Median $33.11 Typical High $45.71 | Professional | None (both parts) | $33.11 | $33.11 | $45.71 |
Medcost Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $44.67 | Professional | None | $33.11 | $33.11 | $44.67 |
Medcost Setting Facility Modifier None Typical Low $21.38 Median $38.02 Typical High $81.28 | Facility | None | $21.38 | $38.02 | $81.28 |
Medcost Setting Professional Modifier None (both parts) Typical Low $34.67 Median $47.86 Typical High $87.10 | Professional | None (both parts) | $34.67 | $47.86 | $87.10 |
Molina Setting Professional Modifier None (both parts) Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None (both parts) | $44.67 | $44.67 | $44.67 |
United Setting Facility Modifier None Typical Low $43.65 Median $52.48 Typical High $89.13 | Facility | None | $43.65 | $52.48 | $89.13 |
United Setting Professional Modifier None (both parts) Typical Low $25.12 Median $33.11 Typical High $41.69 | Professional | None (both parts) | $25.12 | $33.11 | $41.69 |
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 $16.22 Median $16.22 Typical High $20.42 | Professional | 52 · Reduced service | $16.22 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $8.13 | Professional | 53 · Discontinued | $6.61 | $6.61 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $6.17 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $4.07 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $14.13 Median $19.95 Typical High $46.77 | Professional | 26 · Professional part | $14.13 | $19.95 | $46.77 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $54.95 Median $74.13 Typical High $173.78 | Professional | 50 · Both sides | $54.95 | $74.13 | $173.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $18.62 Median $24.55 Typical High $58.88 | Professional | 51 · Multiple procedures | $18.62 | $24.55 | $58.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.41 Median $9.77 Typical High $23.44 | Professional | 80 · Assistant surgeon | $7.41 | $9.77 | $23.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.13 Median $6.92 Typical High $16.22 | Professional | 81 · Minimal assistant surgeon | $5.13 | $6.92 | $16.22 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.13 Median $6.92 Typical High $16.22 | Professional | 82 · Assistant surgeon, no resident | $5.13 | $6.92 | $16.22 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.13 Median $6.92 Typical High $16.22 | Professional | AS · PA/NP assist | $5.13 | $6.92 | $16.22 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $20.89 Median $29.51 Typical High $70.79 | Professional | TC · Technical part | $20.89 | $29.51 | $70.79 |
Where South Carolina sits
The same service costs 3.8 times more in Hawaii than in Florida. 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· 42nd of 51
$39.81
HI $126FL $33.11
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.