How much rates vary
Facilitymedian $100 · 10th to 90th $71 to $162Professionalmedian $95 · 10th to 90th $71 to $162
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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None (both parts) Typical Low $70.79 Median $70.79 Typical High $100.00 | Professional | None (both parts) | $70.79 | $70.79 | $100.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $147.91 Median $162.18 Typical High $162.18 | Facility | None | $147.91 | $162.18 | $162.18 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $95.50 Median $138.04 Typical High $162.18 | Professional | None (both parts) | $95.50 | $138.04 | $162.18 |
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 $100.00 Median $107.15 Typical High $107.15 | Professional | None | $100.00 | $107.15 | $107.15 |
Medcost Setting Facility Modifier None Typical Low $51.29 Median $85.11 Typical High $194.98 | Facility | None | $51.29 | $85.11 | $194.98 |
Medcost Setting Professional Modifier None (both parts) Typical Low $89.13 Median $114.82 Typical High $213.80 | Professional | None (both parts) | $89.13 | $114.82 | $213.80 |
Molina Setting Professional Modifier None (both parts) Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None (both parts) | $107.15 | $107.15 | $107.15 |
United Setting Facility Modifier None Typical Low $102.33 Median $107.15 Typical High $218.78 | Facility | None | $102.33 | $107.15 | $218.78 |
United Setting Professional Modifier None (both parts) Typical Low $61.66 Median $79.43 Typical High $120.23 | Professional | None (both parts) | $61.66 | $79.43 | $120.23 |
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 $35.48 Median $35.48 Typical High $50.12 | Professional | 52 · Reduced service | $35.48 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $20.42 | Professional | 53 · Discontinued | $14.13 | $14.13 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $15.14 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $10.00 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $45.71 Median $47.86 Typical High $112.20 | Professional | 26 · Professional part | $45.71 | $47.86 | $112.20 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $134.90 Median $173.78 Typical High $426.58 | Professional | 50 · Both sides | $134.90 | $173.78 | $426.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $44.67 Median $57.54 Typical High $141.25 | Professional | 51 · Multiple procedures | $44.67 | $57.54 | $141.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.20 Median $22.91 Typical High $56.23 | Professional | 80 · Assistant surgeon | $18.20 | $22.91 | $56.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.59 Median $16.22 Typical High $39.81 | Professional | 81 · Minimal assistant surgeon | $12.59 | $16.22 | $39.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.59 Median $16.22 Typical High $39.81 | Professional | 82 · Assistant surgeon, no resident | $12.59 | $16.22 | $39.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.59 Median $16.22 Typical High $39.81 | Professional | AS · PA/NP assist | $12.59 | $16.22 | $39.81 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $69.18 Median $72.44 Typical High $169.82 | Professional | TC · Technical part | $69.18 | $72.44 | $169.82 |
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· 39th of 51
$95.50
HI $295DE $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.