How much rates vary
Facilitymedian $35 · 10th to 90th $23 to $54Professionalmedian $31 · 10th to 90th $23 to $54
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 $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier None (both parts) Typical Low $22.91 Median $23.44 Typical High $33.11 | Professional | None (both parts) | $22.91 | $23.44 | $33.11 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $36.31 Median $36.31 Typical High $53.70 | Professional | None (both parts) | $36.31 | $36.31 | $53.70 |
BCBS South Carolina Setting Facility Modifier None Typical Low $38.02 Median $53.70 Typical High $53.70 | Facility | None | $38.02 | $53.70 | $53.70 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $30.90 Median $44.67 Typical High $53.70 | Professional | None (both parts) | $30.90 | $44.67 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $34.67 Typical High $34.67 | Facility | None | $30.20 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None (both parts) Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None (both parts) | $25.70 | $25.70 | $34.67 |
Medcost Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $26.30 | Professional | None | $22.39 | $22.39 | $26.30 |
Medcost Setting Facility Modifier None Typical Low $14.13 Median $28.18 Typical High $64.57 | Facility | None | $14.13 | $28.18 | $64.57 |
Medcost Setting Professional Modifier None (both parts) Typical Low $30.20 Median $38.02 Typical High $70.79 | Professional | None (both parts) | $30.20 | $38.02 | $70.79 |
Molina Setting Professional Modifier None (both parts) Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None (both parts) | $35.48 | $35.48 | $35.48 |
United Setting Facility Modifier None Typical Low $16.22 Median $31.62 Typical High $60.26 | Facility | None | $16.22 | $31.62 | $60.26 |
United Setting Professional Modifier None (both parts) Typical Low $18.20 Median $26.30 Typical High $33.88 | Professional | None (both parts) | $18.20 | $26.30 | $33.88 |
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 $11.75 Median $11.75 Typical High $16.22 | Professional | 52 · Reduced service | $11.75 | $11.75 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $4.68 Typical High $6.46 | Professional | 53 · Discontinued | $4.68 | $4.68 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.55 Typical High $4.79 | Professional | 55 · Aftercare only | $3.55 | $3.55 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.34 | $2.34 | $3.24 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $15.14 Median $15.85 Typical High $37.15 | Professional | 26 · Professional part | $15.14 | $15.85 | $37.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $44.67 Median $58.88 Typical High $141.25 | Professional | 50 · Both sides | $44.67 | $58.88 | $141.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.14 Median $19.50 Typical High $46.77 | Professional | 51 · Multiple procedures | $15.14 | $19.50 | $46.77 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.03 Median $7.76 Typical High $18.62 | Professional | 80 · Assistant surgeon | $6.03 | $7.76 | $18.62 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.17 Median $5.50 Typical High $13.18 | Professional | 81 · Minimal assistant surgeon | $4.17 | $5.50 | $13.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.17 Median $5.50 Typical High $13.18 | Professional | 82 · Assistant surgeon, no resident | $4.17 | $5.50 | $13.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.17 Median $5.50 Typical High $13.18 | Professional | AS · PA/NP assist | $4.17 | $5.50 | $13.18 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $22.91 Median $23.99 Typical High $56.23 | Professional | TC · Technical part | $22.91 | $23.99 | $56.23 |
Where South Carolina sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 33rd of 51
$30.90
HI $77.62DC $24.55
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.