How much rates vary
Facilitymedian $100 · 10th to 90th $69 to $155Professionalmedian $89 · 10th to 90th $69 to $155
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 $97.72 | Professional | None (both parts) | $69.18 | $69.18 | $97.72 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None (both parts) | $162.18 | $162.18 | $162.18 |
BCBS South Carolina Setting Facility Modifier None Typical Low $141.25 Median $154.88 Typical High $154.88 | Facility | None | $141.25 | $154.88 | $154.88 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $89.13 Median $128.82 Typical High $154.88 | Professional | None (both parts) | $89.13 | $128.82 | $154.88 |
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 $95.50 Median $102.33 Typical High $102.33 | Professional | None | $95.50 | $102.33 | $102.33 |
Medcost Setting Facility Modifier None Typical Low $48.98 Median $75.86 Typical High $190.55 | Facility | None | $48.98 | $75.86 | $190.55 |
Medcost Setting Professional Modifier None (both parts) Typical Low $85.11 Median $109.65 Typical High $204.17 | Professional | None (both parts) | $85.11 | $109.65 | $204.17 |
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 $60.26 Median $75.86 Typical High $208.93 | Facility | None | $60.26 | $75.86 | $208.93 |
United Setting Professional Modifier None (both parts) Typical Low $60.26 Median $75.86 Typical High $114.82 | Professional | None (both parts) | $60.26 | $75.86 | $114.82 |
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 $34.67 Median $34.67 Typical High $48.98 | Professional | 52 · Reduced service | $34.67 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $19.50 | Professional | 53 · Discontinued | $13.80 | $13.80 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $14.45 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $14.45 |
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 $45.71 Typical High $109.65 | Professional | 26 · Professional part | $43.65 | $45.71 | $109.65 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $128.82 Median $165.96 Typical High $407.38 | Professional | 50 · Both sides | $128.82 | $165.96 | $407.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $42.66 Median $54.95 Typical High $134.90 | Professional | 51 · Multiple procedures | $42.66 | $54.95 | $134.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $17.38 Median $21.88 Typical High $54.95 | Professional | 80 · Assistant surgeon | $17.38 | $21.88 | $54.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.02 Median $15.49 Typical High $38.02 | Professional | 81 · Minimal assistant surgeon | $12.02 | $15.49 | $38.02 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.02 Median $15.49 Typical High $38.02 | Professional | 82 · Assistant surgeon, no resident | $12.02 | $15.49 | $38.02 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.02 Median $15.49 Typical High $38.02 | Professional | AS · PA/NP assist | $12.02 | $15.49 | $38.02 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $66.07 Median $69.18 Typical High $162.18 | Professional | TC · Technical part | $66.07 | $69.18 | $162.18 |
Where South Carolina sits
The same service costs 2.9 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· 40th of 51
$89.13
MT $209FL $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.