How much rates vary
Facilitymedian $66 · 10th to 90th $52 to $107Professionalmedian $62 · 10th to 90th $49 to $107
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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None (both parts) Typical Low $52.48 Median $52.48 Typical High $67.61 | Professional | None (both parts) | $52.48 | $52.48 | $67.61 |
BCBS South Carolina Setting Facility Modifier None Typical Low $97.72 Median $107.15 Typical High $107.15 | Facility | None | $97.72 | $107.15 | $107.15 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $61.66 Median $89.13 Typical High $107.15 | Professional | None (both parts) | $61.66 | $89.13 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None (both parts) Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None (both parts) | $48.98 | $48.98 | $66.07 |
Medcost Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $77.62 | Professional | None | $69.18 | $69.18 | $77.62 |
Medcost Setting Facility Modifier None Typical Low $33.88 Median $63.10 Typical High $131.83 | Facility | None | $33.88 | $63.10 | $131.83 |
Medcost Setting Professional Modifier None (both parts) Typical Low $60.26 Median $75.86 Typical High $141.25 | Professional | None (both parts) | $60.26 | $75.86 | $141.25 |
Molina Setting Professional Modifier None (both parts) Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None (both parts) | $70.79 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $141.25 | Facility | None | $61.66 | $69.18 | $141.25 |
United Setting Professional Modifier None (both parts) Typical Low $39.81 Median $52.48 Typical High $66.07 | Professional | None (both parts) | $39.81 | $52.48 | $66.07 |
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 $26.30 Median $26.30 Typical High $31.62 | Professional | 52 · Reduced service | $26.30 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $12.88 | Professional | 53 · Discontinued | $10.47 | $10.47 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $9.55 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $6.31 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $30.20 Median $31.62 Typical High $75.86 | Professional | 26 · Professional part | $30.20 | $31.62 | $75.86 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $89.13 Median $114.82 Typical High $281.84 | Professional | 50 · Both sides | $89.13 | $114.82 | $281.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.20 Median $38.02 Typical High $93.33 | Professional | 51 · Multiple procedures | $30.20 | $38.02 | $93.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.02 Median $15.14 Typical High $37.15 | Professional | 80 · Assistant surgeon | $12.02 | $15.14 | $37.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.32 Median $10.72 Typical High $26.30 | Professional | 81 · Minimal assistant surgeon | $8.32 | $10.72 | $26.30 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.32 Median $10.72 Typical High $26.30 | Professional | 82 · Assistant surgeon, no resident | $8.32 | $10.72 | $26.30 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.32 Median $10.72 Typical High $26.30 | Professional | AS · PA/NP assist | $8.32 | $10.72 | $26.30 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $45.71 Median $47.86 Typical High $112.20 | Professional | TC · Technical part | $45.71 | $47.86 | $112.20 |
Where South Carolina sits
The same service costs 3.5 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· 43rd of 51
$61.66
HI $174FL $48.98
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.