How much rates vary
Facilitymedian $68 · 10th to 90th $56 to $120Professionalmedian $69 · 10th to 90th $54 to $120
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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None (both parts) Typical Low $58.88 Median $58.88 Typical High $104.71 | Professional | None (both parts) | $58.88 | $58.88 | $104.71 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $100.00 Median $100.00 Typical High $125.89 | Professional | None (both parts) | $100.00 | $100.00 | $125.89 |
BCBS South Carolina Setting Facility Modifier None Typical Low $20.42 Median $109.65 Typical High $120.23 | Facility | None | $20.42 | $109.65 | $120.23 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $69.18 Median $100.00 Typical High $120.23 | Professional | None (both parts) | $69.18 | $100.00 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $72.44 | Facility | None | $67.61 | $67.61 | $72.44 |
Cigna Setting Professional Modifier None (both parts) Typical Low $50.12 Median $50.12 Typical High $72.44 | Professional | None (both parts) | $50.12 | $50.12 | $72.44 |
Medcost Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $67.61 | Professional | None | $51.29 | $51.29 | $67.61 |
Medcost Setting Facility Modifier None Typical Low $32.36 Median $61.66 Typical High $144.54 | Facility | None | $32.36 | $61.66 | $144.54 |
Medcost Setting Professional Modifier None (both parts) Typical Low $67.61 Median $85.11 Typical High $158.49 | Professional | None (both parts) | $67.61 | $85.11 | $158.49 |
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 $67.61 Median $77.62 Typical High $138.04 | Facility | None | $67.61 | $77.62 | $138.04 |
United Setting Professional Modifier None (both parts) Typical Low $39.81 Median $57.54 Typical High $70.79 | Professional | None (both parts) | $39.81 | $57.54 | $70.79 |
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 $35.48 | Professional | 52 · Reduced service | $29.51 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $14.13 | Professional | 53 · Discontinued | $11.75 | $11.75 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $10.72 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $7.08 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $33.88 Median $35.48 Typical High $83.18 | Professional | 26 · Professional part | $33.88 | $35.48 | $83.18 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $128.82 Typical High $316.23 | Professional | 50 · Both sides | $100.00 | $128.82 | $316.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.88 Median $43.65 Typical High $104.71 | Professional | 51 · Multiple procedures | $33.88 | $43.65 | $104.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.49 Median $16.98 Typical High $41.69 | Professional | 80 · Assistant surgeon | $13.49 | $16.98 | $41.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.33 Median $12.02 Typical High $29.51 | Professional | 81 · Minimal assistant surgeon | $9.33 | $12.02 | $29.51 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.33 Median $12.02 Typical High $29.51 | Professional | 82 · Assistant surgeon, no resident | $9.33 | $12.02 | $29.51 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.33 Median $12.02 Typical High $29.51 | Professional | AS · PA/NP assist | $9.33 | $12.02 | $29.51 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $51.29 Median $53.70 Typical High $125.89 | Professional | TC · Technical part | $51.29 | $53.70 | $125.89 |
Where South Carolina sits
The same service costs 4.1 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· 24th of 51
$69.18
HI $209DE $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.