How much rates vary
Facilitymedian $5 · 10th to 90th $4 to $8Professionalmedian $5 · 10th to 90th $4 to $8
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 $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier None (both parts) Typical Low $3.55 Median $3.55 Typical High $5.89 | Professional | None (both parts) | $3.55 | $3.55 | $5.89 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $3.98 Median $3.98 Typical High $8.13 | Professional | None (both parts) | $3.98 | $3.98 | $8.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $7.41 Median $8.13 Typical High $8.13 | Facility | None | $7.41 | $8.13 | $8.13 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $5.01 Median $5.01 Typical High $8.13 | Professional | None (both parts) | $5.01 | $5.01 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
Cigna Setting Professional Modifier None (both parts) Typical Low $3.80 Median $3.80 Typical High $5.13 | Professional | None (both parts) | $3.80 | $3.80 | $5.13 |
Medcost Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Medcost Setting Facility Modifier None Typical Low $2.57 Median $3.98 Typical High $9.77 | Facility | None | $2.57 | $3.98 | $9.77 |
Medcost Setting Professional Modifier None (both parts) Typical Low $5.01 Median $6.03 Typical High $10.72 | Professional | None (both parts) | $5.01 | $6.03 | $10.72 |
Molina Setting Professional Modifier None (both parts) Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None (both parts) | $5.37 | $5.37 | $5.37 |
United Setting Facility Modifier None Typical Low $4.79 Median $5.37 Typical High $10.96 | Facility | None | $4.79 | $5.37 | $10.96 |
United Setting Professional Modifier None (both parts) Typical Low $3.16 Median $3.98 Typical High $6.03 | Professional | None (both parts) | $3.16 | $3.98 | $6.03 |
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 $1.78 Median $1.78 Typical High $2.51 | Professional | 52 · Reduced service | $1.78 | $1.78 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.72 Typical High $1.00 | Professional | 53 · Discontinued | $0.72 | $0.72 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.54 Median $0.54 Typical High $0.76 | Professional | 55 · Aftercare only | $0.54 | $0.54 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.51 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $2.40 Median $2.40 Typical High $5.62 | Professional | 26 · Professional part | $2.40 | $2.40 | $5.62 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $7.59 Median $8.91 Typical High $21.38 | Professional | 50 · Both sides | $7.59 | $8.91 | $21.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.51 Median $3.02 Typical High $7.08 | Professional | 51 · Multiple procedures | $2.51 | $3.02 | $7.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.00 Median $1.20 Typical High $2.82 | Professional | 80 · Assistant surgeon | $1.00 | $1.20 | $2.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.71 Median $0.83 Typical High $2.00 | Professional | 81 · Minimal assistant surgeon | $0.71 | $0.83 | $2.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.71 Median $0.83 Typical High $2.00 | Professional | 82 · Assistant surgeon, no resident | $0.71 | $0.83 | $2.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.71 Median $0.83 Typical High $2.00 | Professional | AS · PA/NP assist | $0.71 | $0.83 | $2.00 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $3.63 Median $3.63 Typical High $8.51 | Professional | TC · Technical part | $3.63 | $3.63 | $8.51 |
Where South Carolina sits
The same service costs 3.2 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· 36th of 51
$5.01
HI $12.02DE $3.80
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.