How much rates vary
Facilitymedian $14 · 10th to 90th $10 to $23Professionalmedian $15 · 10th to 90th $10 to $23
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 $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier None (both parts) Typical Low $10.23 Median $10.23 Typical High $14.45 | Professional | None (both parts) | $10.23 | $10.23 | $14.45 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None (both parts) | $11.22 | $11.22 | $11.22 |
BCBS South Carolina Setting Facility Modifier None Typical Low $20.89 Median $23.44 Typical High $23.44 | Facility | None | $20.89 | $23.44 | $23.44 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $14.13 Median $15.14 Typical High $23.44 | Professional | None (both parts) | $14.13 | $15.14 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None (both parts) Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None (both parts) | $10.47 | $10.47 | $14.45 |
Medcost Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $12.59 | Professional | None | $9.55 | $9.55 | $12.59 |
Medcost Setting Facility Modifier None Typical Low $6.03 Median $11.22 Typical High $28.18 | Facility | None | $6.03 | $11.22 | $28.18 |
Medcost Setting Professional Modifier None (both parts) Typical Low $12.88 Median $16.98 Typical High $30.20 | Professional | None (both parts) | $12.88 | $16.98 | $30.20 |
Molina Setting Professional Modifier None (both parts) Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None (both parts) | $15.49 | $15.49 | $15.49 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.88 Typical High $25.70 | Facility | None | $12.59 | $12.88 | $25.70 |
United Setting Professional Modifier None (both parts) Typical Low $7.94 Median $11.22 Typical High $14.13 | Professional | None (both parts) | $7.94 | $11.22 | $14.13 |
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 $5.13 Median $5.13 Typical High $7.24 | Professional | 52 · Reduced service | $5.13 | $5.13 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.04 Typical High $2.88 | Professional | 53 · Discontinued | $2.04 | $2.04 | $2.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $2.14 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $1.02 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.02 | $1.02 | $1.45 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $6.76 Median $6.92 Typical High $16.22 | Professional | 26 · Professional part | $6.76 | $6.92 | $16.22 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $19.50 Median $25.70 Typical High $60.26 | Professional | 50 · Both sides | $19.50 | $25.70 | $60.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.46 Median $8.51 Typical High $19.95 | Professional | 51 · Multiple procedures | $6.46 | $8.51 | $19.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.57 Median $3.39 Typical High $8.13 | Professional | 80 · Assistant surgeon | $2.57 | $3.39 | $8.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.82 Median $2.40 Typical High $5.62 | Professional | 81 · Minimal assistant surgeon | $1.82 | $2.40 | $5.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.82 Median $2.40 Typical High $5.62 | Professional | 82 · Assistant surgeon, no resident | $1.82 | $2.40 | $5.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.82 Median $2.40 Typical High $5.62 | Professional | AS · PA/NP assist | $1.82 | $2.40 | $5.62 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $10.23 Median $10.23 Typical High $23.99 | Professional | TC · Technical part | $10.23 | $10.23 | $23.99 |
Where South Carolina sits
The same service costs 3.0 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· 18th of 51
$15.14
HI $31.62DE $10.47
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.