How much rates vary
Facilitymedian $56 · 10th to 90th $47 to $95Professionalmedian $60 · 10th to 90th $42 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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None (both parts) Typical Low $46.77 Median $46.77 Typical High $57.54 | Professional | None (both parts) | $46.77 | $46.77 | $57.54 |
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 $58.88 Median $60.26 Typical High $95.50 | Professional | None (both parts) | $58.88 | $60.26 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $64.57 | Facility | None | $56.23 | $56.23 | $64.57 |
Cigna Setting Professional Modifier None (both parts) Typical Low $41.69 Median $41.69 Typical High $63.10 | Professional | None (both parts) | $41.69 | $41.69 | $63.10 |
Medcost Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $54.95 | Professional | None | $46.77 | $46.77 | $54.95 |
Medcost Setting Facility Modifier None Typical Low $26.92 Median $51.29 Typical High $114.82 | Facility | None | $26.92 | $51.29 | $114.82 |
Medcost Setting Professional Modifier None (both parts) Typical Low $52.48 Median $67.61 Typical High $125.89 | Professional | None (both parts) | $52.48 | $67.61 | $125.89 |
United Setting Facility Modifier None Typical Low $44.67 Median $112.20 Typical High $112.20 | Facility | None | $44.67 | $112.20 | $112.20 |
United Setting Professional Modifier None (both parts) Typical Low $31.62 Median $45.71 Typical High $56.23 | Professional | None (both parts) | $31.62 | $45.71 | $56.23 |
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 $28.18 | Professional | 52 · Reduced service | $22.91 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $11.22 | Professional | 53 · Discontinued | $9.33 | $9.33 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $8.51 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $5.62 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $28.18 Typical High $66.07 | Professional | 26 · Professional part | $26.92 | $28.18 | $66.07 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $79.43 Median $102.33 Typical High $251.19 | Professional | 50 · Both sides | $79.43 | $102.33 | $251.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.30 Median $33.88 Typical High $83.18 | Professional | 51 · Multiple procedures | $26.30 | $33.88 | $83.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.72 Median $13.49 Typical High $33.11 | Professional | 80 · Assistant surgeon | $10.72 | $13.49 | $33.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.41 Median $9.55 Typical High $23.44 | Professional | 81 · Minimal assistant surgeon | $7.41 | $9.55 | $23.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.41 Median $9.55 Typical High $23.44 | Professional | 82 · Assistant surgeon, no resident | $7.41 | $9.55 | $23.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.41 Median $9.55 Typical High $23.44 | Professional | AS · PA/NP assist | $7.41 | $9.55 | $23.44 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $40.74 Median $42.66 Typical High $100.00 | Professional | TC · Technical part | $40.74 | $42.66 | $100.00 |
Where South Carolina sits
The same service costs 2.6 times more in Kansas than in Arizona. 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· 21st of 51
$60.26
KS $107AZ $41.69
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.