How much rates vary
Facilitymedian $17 · 10th to 90th $11 to $26Professionalmedian $15 · 10th to 90th $11 to $26
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 $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier None (both parts) Typical Low $11.48 Median $11.48 Typical High $16.22 | Professional | None (both parts) | $11.48 | $11.48 | $16.22 |
BCBS South Carolina Setting Facility Modifier None Typical Low $23.99 Median $26.30 Typical High $26.30 | Facility | None | $23.99 | $26.30 | $26.30 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $15.14 Median $22.39 Typical High $26.30 | Professional | None (both parts) | $15.14 | $22.39 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None (both parts) Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | None (both parts) | $12.02 | $12.02 | $16.60 |
Medcost Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $16.60 | Professional | None | $13.80 | $13.80 | $16.60 |
Medcost Setting Facility Modifier None Typical Low $7.94 Median $12.88 Typical High $31.62 | Facility | None | $7.94 | $12.88 | $31.62 |
Medcost Setting Professional Modifier None (both parts) Typical Low $15.14 Median $19.05 Typical High $34.67 | Professional | None (both parts) | $15.14 | $19.05 | $34.67 |
Molina Setting Professional Modifier None (both parts) Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None (both parts) | $17.38 | $17.38 | $17.38 |
United Setting Facility Modifier None Typical Low $12.88 Median $16.22 Typical High $33.88 | Facility | None | $12.88 | $16.22 | $33.88 |
United Setting Professional Modifier None (both parts) Typical Low $10.00 Median $12.88 Typical High $18.62 | Professional | None (both parts) | $10.00 | $12.88 | $18.62 |
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 $5.75 Median $5.75 Typical High $8.13 | Professional | 52 · Reduced service | $5.75 | $5.75 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $3.31 | Professional | 53 · Discontinued | $2.29 | $2.29 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $2.45 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.15 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.15 | $1.15 | $1.62 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $7.59 Median $7.76 Typical High $18.20 | Professional | 26 · Professional part | $7.59 | $7.76 | $18.20 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $22.39 Median $28.18 Typical High $69.18 | Professional | 50 · Both sides | $22.39 | $28.18 | $69.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $7.59 Median $9.55 Typical High $22.91 | Professional | 51 · Multiple procedures | $7.59 | $9.55 | $22.91 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.02 Median $3.80 Typical High $9.12 | Professional | 80 · Assistant surgeon | $3.02 | $3.80 | $9.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.09 Median $2.63 Typical High $6.46 | Professional | 81 · Minimal assistant surgeon | $2.09 | $2.63 | $6.46 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.09 Median $2.63 Typical High $6.46 | Professional | 82 · Assistant surgeon, no resident | $2.09 | $2.63 | $6.46 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.09 Median $2.63 Typical High $6.46 | Professional | AS · PA/NP assist | $2.09 | $2.63 | $6.46 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $11.48 Median $11.75 Typical High $27.54 | Professional | TC · Technical part | $11.48 | $11.75 | $27.54 |
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· 41st of 51
$15.14
HI $36.31DE $12.02
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.