How much rates vary
Facilitymedian $54 · 10th to 90th $46 to $95Professionalmedian $47 · 10th to 90th $39 to $95
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 $58.88 | Professional | None (both parts) | $45.71 | $45.71 | $58.88 |
BCBS South Carolina Setting Facility Modifier None Typical Low $85.11 Median $95.50 Typical High $95.50 | Facility | None | $85.11 | $95.50 | $95.50 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $40.74 Median $95.50 Typical High $95.50 | Professional | None (both parts) | $40.74 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None (both parts) Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | None (both parts) | $38.90 | $38.90 | $53.70 |
Medcost Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Medcost Setting Facility Modifier None Typical Low $45.71 Median $61.66 Typical High $114.82 | Facility | None | $45.71 | $61.66 | $114.82 |
Medcost Setting Professional Modifier None (both parts) Typical Low $38.90 Median $50.12 Typical High $123.03 | Professional | None (both parts) | $38.90 | $50.12 | $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 $16.98 Median $39.81 Typical High $117.49 | Facility | None | $16.98 | $39.81 | $117.49 |
United Setting Professional Modifier None (both parts) Typical Low $33.88 Median $45.71 Typical High $66.07 | Professional | None (both parts) | $33.88 | $45.71 | $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 $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 $11.22 | Professional | 53 · Discontinued | $9.12 | $9.12 | $11.22 |
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 $5.62 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $5.62 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $19.95 Median $28.84 Typical High $66.07 | Professional | 26 · Professional part | $19.95 | $28.84 | $66.07 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $58.88 Median $75.86 Typical High $245.47 | Professional | 50 · Both sides | $58.88 | $75.86 | $245.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.50 Median $25.12 Typical High $81.28 | Professional | 51 · Multiple procedures | $19.50 | $25.12 | $81.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.76 Median $10.00 Typical High $33.11 | Professional | 80 · Assistant surgeon | $7.76 | $10.00 | $33.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.50 Median $7.08 Typical High $22.91 | Professional | 81 · Minimal assistant surgeon | $5.50 | $7.08 | $22.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.50 Median $7.08 Typical High $22.91 | Professional | 82 · Assistant surgeon, no resident | $5.50 | $7.08 | $22.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.50 Median $7.08 Typical High $22.91 | Professional | AS · PA/NP assist | $5.50 | $7.08 | $22.91 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $30.20 Median $43.65 Typical High $97.72 | Professional | TC · Technical part | $30.20 | $43.65 | $97.72 |
Where South Carolina sits
The same service costs 3.3 times more in Hawaii 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· 36th of 51
$50.12
HI $135DE $40.74
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.