How much rates vary
Facilitymedian $100 · 10th to 90th $69 to $158Professionalmedian $105 · 10th to 90th $69 to $158
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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None (both parts) Typical Low $69.18 Median $69.18 Typical High $114.82 | Professional | None (both parts) | $69.18 | $69.18 | $114.82 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $120.23 Median $158.49 Typical High $158.49 | Professional | None (both parts) | $120.23 | $158.49 | $158.49 |
BCBS South Carolina Setting Facility Modifier None Typical Low $141.25 Median $158.49 Typical High $158.49 | Facility | None | $141.25 | $158.49 | $158.49 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $95.50 Median $104.71 Typical High $158.49 | Professional | None (both parts) | $95.50 | $104.71 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None (both parts) Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None (both parts) | $72.44 | $72.44 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Medcost Setting Facility Modifier None Typical Low $44.67 Median $75.86 Typical High $190.55 | Facility | None | $44.67 | $75.86 | $190.55 |
Medcost Setting Professional Modifier None (both parts) Typical Low $109.65 Median $109.65 Typical High $208.93 | Professional | None (both parts) | $109.65 | $109.65 | $208.93 |
Molina Setting Professional Modifier None (both parts) Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None (both parts) | $104.71 | $104.71 | $104.71 |
United Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
United Setting Professional Modifier None (both parts) Typical Low $57.54 Median $77.62 Typical High $104.71 | Professional | None (both parts) | $57.54 | $77.62 | $104.71 |
10 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 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $14.79 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $9.77 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $43.65 Median $46.77 Typical High $109.65 | Professional | 26 · Professional part | $43.65 | $46.77 | $109.65 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $173.78 Typical High $416.87 | Professional | 50 · Both sides | $162.18 | $173.78 | $416.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $54.95 Median $57.54 Typical High $138.04 | Professional | 51 · Multiple procedures | $54.95 | $57.54 | $138.04 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $21.88 Median $22.91 Typical High $54.95 | Professional | 80 · Assistant surgeon | $21.88 | $22.91 | $54.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.14 Median $16.22 Typical High $38.90 | Professional | 81 · Minimal assistant surgeon | $15.14 | $16.22 | $38.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.14 Median $16.22 Typical High $38.90 | Professional | 82 · Assistant surgeon, no resident | $15.14 | $16.22 | $38.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.14 Median $16.22 Typical High $38.90 | Professional | AS · PA/NP assist | $15.14 | $16.22 | $38.90 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $66.07 Median $70.79 Typical High $165.96 | Professional | TC · Technical part | $66.07 | $70.79 | $165.96 |
Where South Carolina sits
The same service costs 2.2 times more in Montana than in Florida. 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
$105
MT $158FL $72.44
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.