How much rates vary
Facilitymedian $62 · 10th to 90th $48 to $98Professionalmedian $48 · 10th to 90th $30 to $98
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 $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None (both parts) Typical Low $47.86 Median $47.86 Typical High $83.18 | Professional | None (both parts) | $47.86 | $47.86 | $83.18 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None (both parts) | $100.00 | $100.00 | $100.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $87.10 Median $97.72 Typical High $97.72 | Facility | None | $87.10 | $97.72 | $97.72 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $44.67 Typical High $97.72 | Professional | None (both parts) | $30.20 | $44.67 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $67.61 | Facility | None | $60.26 | $61.66 | $67.61 |
Cigna Setting Professional Modifier None (both parts) Typical Low $44.67 Median $44.67 Typical High $83.18 | Professional | None (both parts) | $44.67 | $44.67 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Medcost Setting Facility Modifier None Typical Low $47.86 Median $58.88 Typical High $117.49 | Facility | None | $47.86 | $58.88 | $117.49 |
Medcost Setting Professional Modifier None (both parts) Typical Low $75.86 Median $83.18 Typical High $128.82 | Professional | None (both parts) | $75.86 | $83.18 | $128.82 |
Molina Setting Professional Modifier None (both parts) Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None (both parts) | $64.57 | $64.57 | $64.57 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $131.83 | Facility | None | $72.44 | $72.44 | $131.83 |
United Setting Professional Modifier None (both parts) Typical Low $36.31 Median $47.86 Typical High $67.61 | Professional | None (both parts) | $36.31 | $47.86 | $67.61 |
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 $23.99 Median $23.99 Typical High $28.84 | Professional | 52 · Reduced service | $23.99 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $11.48 | Professional | 53 · Discontinued | $9.55 | $9.55 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $8.71 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $5.75 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $30.20 Median $39.81 Typical High $67.61 | Professional | 26 · Professional part | $30.20 | $39.81 | $67.61 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $117.49 Typical High $257.04 | Professional | 50 · Both sides | $112.20 | $117.49 | $257.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $37.15 Median $38.90 Typical High $85.11 | Professional | 51 · Multiple procedures | $37.15 | $38.90 | $85.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.14 Median $15.49 Typical High $33.88 | Professional | 80 · Assistant surgeon | $15.14 | $15.49 | $33.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.47 Median $10.96 Typical High $23.99 | Professional | 81 · Minimal assistant surgeon | $10.47 | $10.96 | $23.99 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.47 Median $10.96 Typical High $23.99 | Professional | 82 · Assistant surgeon, no resident | $10.47 | $10.96 | $23.99 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.47 Median $10.96 Typical High $23.99 | Professional | AS · PA/NP assist | $10.47 | $10.96 | $23.99 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $44.67 Median $60.26 Typical High $102.33 | Professional | TC · Technical part | $44.67 | $60.26 | $102.33 |
Where South Carolina sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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· 46th of 51
$51.29
WI $100NJ $47.86
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.