How much rates vary
Facilitymedian $85 · 10th to 90th $60 to $123Professionalmedian $71 · 10th to 90th $58 to $123
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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None (both parts) Typical Low $60.26 Median $60.26 Typical High $72.44 | Professional | None (both parts) | $60.26 | $60.26 | $72.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $109.65 Median $123.03 Typical High $123.03 | Facility | None | $109.65 | $123.03 | $123.03 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $70.79 Median $100.00 Typical High $123.03 | Professional | None (both parts) | $70.79 | $100.00 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $61.66 Median $61.66 Typical High $85.11 | Professional | None (both parts) | $61.66 | $61.66 | $85.11 |
Medcost Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $77.62 | Professional | None | $57.54 | $57.54 | $77.62 |
Medcost Setting Facility Modifier None Typical Low $36.31 Median $70.79 Typical High $147.91 | Facility | None | $36.31 | $70.79 | $147.91 |
Medcost Setting Professional Modifier None (both parts) Typical Low $67.61 Median $87.10 Typical High $162.18 | Professional | None (both parts) | $67.61 | $87.10 | $162.18 |
Molina Setting Professional Modifier None (both parts) Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None (both parts) | $81.28 | $81.28 | $81.28 |
United Setting Facility Modifier None Typical Low $48.98 Median $64.57 Typical High $154.88 | Facility | None | $48.98 | $64.57 | $154.88 |
United Setting Professional Modifier None (both parts) Typical Low $43.65 Median $58.88 Typical High $75.86 | Professional | None (both parts) | $43.65 | $58.88 | $75.86 |
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 $29.51 Median $29.51 Typical High $36.31 | Professional | 52 · Reduced service | $29.51 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $14.45 | Professional | 53 · Discontinued | $12.02 | $12.02 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $10.96 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $7.24 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $34.67 Median $36.31 Typical High $85.11 | Professional | 26 · Professional part | $34.67 | $36.31 | $85.11 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $131.83 Typical High $316.23 | Professional | 50 · Both sides | $102.33 | $131.83 | $316.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.88 Median $43.65 Typical High $107.15 | Professional | 51 · Multiple procedures | $33.88 | $43.65 | $107.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.49 Median $17.38 Typical High $42.66 | Professional | 80 · Assistant surgeon | $13.49 | $17.38 | $42.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.55 Median $12.30 Typical High $29.51 | Professional | 81 · Minimal assistant surgeon | $9.55 | $12.30 | $29.51 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.55 Median $12.30 Typical High $29.51 | Professional | 82 · Assistant surgeon, no resident | $9.55 | $12.30 | $29.51 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.55 Median $12.30 Typical High $29.51 | Professional | AS · PA/NP assist | $9.55 | $12.30 | $29.51 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $52.48 Median $53.70 Typical High $128.82 | Professional | TC · Technical part | $52.48 | $53.70 | $128.82 |
Where South Carolina sits
The same service costs 2.2 times more in Hawaii than in Alabama. 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· 29th of 51
$70.79
HI $138AL $61.66
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.