How much rates vary
Facilitymedian $45 · 10th to 90th $28 to $63Professionalmedian $36 · 10th to 90th $28 to $63
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 $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $27.54 Median $27.54 Typical High $38.90 | Professional | None (both parts) | $27.54 | $27.54 | $38.90 |
BCBS South Carolina Setting Facility Modifier None Typical Low $56.23 Median $63.10 Typical High $63.10 | Facility | None | $56.23 | $63.10 | $63.10 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $36.31 Median $51.29 Typical High $63.10 | Professional | None (both parts) | $36.31 | $51.29 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Cigna Setting Professional Modifier None (both parts) Typical Low $33.11 Median $33.11 Typical High $44.67 | Professional | None (both parts) | $33.11 | $33.11 | $44.67 |
Medcost Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $46.77 | Professional | None | $32.36 | $32.36 | $46.77 |
Medcost Setting Facility Modifier None Typical Low $19.95 Median $30.20 Typical High $75.86 | Facility | None | $19.95 | $30.20 | $75.86 |
Medcost Setting Professional Modifier None (both parts) Typical Low $33.88 Median $43.65 Typical High $81.28 | Professional | None (both parts) | $33.88 | $43.65 | $81.28 |
Molina Setting Professional Modifier None (both parts) Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None (both parts) | $41.69 | $41.69 | $41.69 |
United Setting Facility Modifier None Typical Low $36.31 Median $37.15 Typical High $83.18 | Facility | None | $36.31 | $37.15 | $83.18 |
United Setting Professional Modifier None (both parts) Typical Low $23.99 Median $30.90 Typical High $45.71 | Professional | None (both parts) | $23.99 | $30.90 | $45.71 |
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 $13.80 Median $13.80 Typical High $19.50 | Professional | 52 · Reduced service | $13.80 | $13.80 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.50 Typical High $7.76 | Professional | 53 · Discontinued | $5.50 | $5.50 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $5.75 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $3.89 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $17.78 Median $18.62 Typical High $43.65 | Professional | 26 · Professional part | $17.78 | $18.62 | $43.65 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $51.29 Median $66.07 Typical High $162.18 | Professional | 50 · Both sides | $51.29 | $66.07 | $162.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $16.98 Median $21.88 Typical High $53.70 | Professional | 51 · Multiple procedures | $16.98 | $21.88 | $53.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.76 Median $8.71 Typical High $21.88 | Professional | 80 · Assistant surgeon | $6.76 | $8.71 | $21.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.79 Median $6.17 Typical High $15.14 | Professional | 81 · Minimal assistant surgeon | $4.79 | $6.17 | $15.14 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.79 Median $6.17 Typical High $15.14 | Professional | 82 · Assistant surgeon, no resident | $4.79 | $6.17 | $15.14 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.79 Median $6.17 Typical High $15.14 | Professional | AS · PA/NP assist | $4.79 | $6.17 | $15.14 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $26.30 Median $27.54 Typical High $64.57 | Professional | TC · Technical part | $26.30 | $27.54 | $64.57 |
Where South Carolina sits
The same service costs 2.5 times more in Hawaii 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· 46th of 51
$36.31
HI $81.28FL $33.11
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.