How much rates vary
Facilitymedian $16 · 10th to 90th $13 to $31Professionalmedian $18 · 10th to 90th $13 to $31
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 $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier None (both parts) Typical Low $13.49 Median $13.49 Typical High $22.39 | Professional | None (both parts) | $13.49 | $13.49 | $22.39 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $14.79 Median $26.30 Typical High $26.30 | Professional | None (both parts) | $14.79 | $26.30 | $26.30 |
BCBS South Carolina Setting Facility Modifier None Typical Low $27.54 Median $30.90 Typical High $30.90 | Facility | None | $27.54 | $30.90 | $30.90 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $18.20 Median $25.70 Typical High $30.90 | Professional | None (both parts) | $18.20 | $25.70 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None (both parts) Typical Low $12.02 Median $12.02 Typical High $18.20 | Professional | None (both parts) | $12.02 | $12.02 | $18.20 |
Medcost Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $14.79 | Professional | None | $12.59 | $12.59 | $14.79 |
Medcost Setting Facility Modifier None Typical Low $7.59 Median $14.79 Typical High $37.15 | Facility | None | $7.59 | $14.79 | $37.15 |
Medcost Setting Professional Modifier None (both parts) Typical Low $16.98 Median $21.88 Typical High $39.81 | Professional | None (both parts) | $16.98 | $21.88 | $39.81 |
Molina Setting Professional Modifier None (both parts) Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None (both parts) | $20.42 | $20.42 | $20.42 |
United Setting Facility Modifier None Typical Low $12.88 Median $15.49 Typical High $31.62 | Facility | None | $12.88 | $15.49 | $31.62 |
United Setting Professional Modifier None (both parts) Typical Low $10.00 Median $14.79 Typical High $18.20 | Professional | None (both parts) | $10.00 | $14.79 | $18.20 |
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 $6.76 Median $6.76 Typical High $9.12 | Professional | 52 · Reduced service | $6.76 | $6.76 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.69 Typical High $3.63 | Professional | 53 · Discontinued | $2.69 | $2.69 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.04 Typical High $2.69 | Professional | 55 · Aftercare only | $2.04 | $2.04 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.35 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.35 | $1.35 | $1.82 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $8.71 Median $9.12 Typical High $21.38 | Professional | 26 · Professional part | $8.71 | $9.12 | $21.38 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $25.70 Median $33.11 Typical High $79.43 | Professional | 50 · Both sides | $25.70 | $33.11 | $79.43 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $8.51 Median $10.96 Typical High $26.92 | Professional | 51 · Multiple procedures | $8.51 | $10.96 | $26.92 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.39 Median $4.37 Typical High $10.72 | Professional | 80 · Assistant surgeon | $3.39 | $4.37 | $10.72 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.40 Median $3.09 Typical High $7.41 | Professional | 81 · Minimal assistant surgeon | $2.40 | $3.09 | $7.41 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.40 Median $3.09 Typical High $7.41 | Professional | 82 · Assistant surgeon, no resident | $2.40 | $3.09 | $7.41 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.40 Median $3.09 Typical High $7.41 | Professional | AS · PA/NP assist | $2.40 | $3.09 | $7.41 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $13.18 Median $13.49 Typical High $31.62 | Professional | TC · Technical part | $13.18 | $13.49 | $31.62 |
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· 21st of 51
$18.20
HI $35.48DE $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.