How much rates vary
Facilitymedian $71 · 10th to 90th $58 to $117Professionalmedian $58 · 10th to 90th $30 to $117
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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $57.54 Median $57.54 Typical High $72.44 | Professional | None (both parts) | $57.54 | $57.54 | $72.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $107.15 Median $117.49 Typical High $117.49 | Facility | None | $107.15 | $117.49 | $117.49 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $44.67 Typical High $117.49 | Professional | None (both parts) | $30.20 | $44.67 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None (both parts) Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None (both parts) | $51.29 | $51.29 | $70.79 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Medcost Setting Facility Modifier None Typical Low $57.54 Median $69.18 Typical High $144.54 | Facility | None | $57.54 | $69.18 | $144.54 |
Medcost Setting Professional Modifier None (both parts) Typical Low $52.48 Median $67.61 Typical High $154.88 | Professional | None (both parts) | $52.48 | $67.61 | $154.88 |
Molina Setting Professional Modifier None (both parts) Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None (both parts) | $79.43 | $79.43 | $79.43 |
United Setting Facility Modifier None Typical Low $57.54 Median $63.10 Typical High $141.25 | Facility | None | $57.54 | $63.10 | $141.25 |
United Setting Professional Modifier None (both parts) Typical Low $40.74 Median $57.54 Typical High $81.28 | Professional | None (both parts) | $40.74 | $57.54 | $81.28 |
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 $28.84 Median $28.84 Typical High $34.67 | Professional | 52 · Reduced service | $28.84 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $14.13 | Professional | 53 · Discontinued | $11.48 | $11.48 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $10.47 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $6.92 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $36.31 Typical High $83.18 | Professional | 26 · Professional part | $26.92 | $36.31 | $83.18 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $79.43 Median $102.33 Typical High $309.03 | Professional | 50 · Both sides | $79.43 | $102.33 | $309.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.30 Median $33.88 Typical High $102.33 | Professional | 51 · Multiple procedures | $26.30 | $33.88 | $102.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.72 Median $13.49 Typical High $41.69 | Professional | 80 · Assistant surgeon | $10.72 | $13.49 | $41.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.41 Median $9.55 Typical High $28.84 | Professional | 81 · Minimal assistant surgeon | $7.41 | $9.55 | $28.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.41 Median $9.55 Typical High $28.84 | Professional | 82 · Assistant surgeon, no resident | $7.41 | $9.55 | $28.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.41 Median $9.55 Typical High $28.84 | Professional | AS · PA/NP assist | $7.41 | $9.55 | $28.84 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $40.74 Median $54.95 Typical High $123.03 | Professional | TC · Technical part | $40.74 | $54.95 | $123.03 |
Where South Carolina sits
The same service costs 2.4 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· 43rd of 51
$57.54
MT $123DE $51.29
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.