How much rates vary
Facilitymedian $69 · 10th to 90th $40 to $89Professionalmedian $46 · 10th to 90th $25 to $89
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 $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier None (both parts) Typical Low $39.81 Median $39.81 Typical High $56.23 | Professional | None (both parts) | $39.81 | $39.81 | $56.23 |
BCBS South Carolina Setting Facility Modifier None Typical Low $81.28 Median $89.13 Typical High $89.13 | Facility | None | $81.28 | $89.13 | $89.13 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $25.12 Median $40.74 Typical High $89.13 | Professional | None (both parts) | $25.12 | $40.74 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None (both parts) Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None (both parts) | $58.88 | $58.88 | $69.18 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Medcost Setting Facility Modifier None Typical Low $25.12 Median $43.65 Typical High $109.65 | Facility | None | $25.12 | $43.65 | $109.65 |
Medcost Setting Professional Modifier None (both parts) Typical Low $52.48 Median $61.66 Typical High $117.49 | Professional | None (both parts) | $52.48 | $61.66 | $117.49 |
Molina Setting Professional Modifier None (both parts) Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None (both parts) | $60.26 | $60.26 | $60.26 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
United Setting Professional Modifier None (both parts) Typical Low $32.36 Median $43.65 Typical High $58.88 | Professional | None (both parts) | $32.36 | $43.65 | $58.88 |
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 $19.95 Median $19.95 Typical High $27.54 | Professional | 52 · Reduced service | $19.95 | $19.95 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $11.22 | Professional | 53 · Discontinued | $7.94 | $7.94 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $8.32 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $5.62 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $24.55 Median $26.30 Typical High $63.10 | Professional | 26 · Professional part | $24.55 | $26.30 | $63.10 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $79.43 Median $97.72 Typical High $234.42 | Professional | 50 · Both sides | $79.43 | $97.72 | $234.42 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.30 Median $33.11 Typical High $77.62 | Professional | 51 · Multiple procedures | $26.30 | $33.11 | $77.62 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.72 Median $13.18 Typical High $30.90 | Professional | 80 · Assistant surgeon | $10.72 | $13.18 | $30.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.41 Median $9.12 Typical High $21.88 | Professional | 81 · Minimal assistant surgeon | $7.41 | $9.12 | $21.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.41 Median $9.12 Typical High $21.88 | Professional | 82 · Assistant surgeon, no resident | $7.41 | $9.12 | $21.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.41 Median $9.12 Typical High $21.88 | Professional | AS · PA/NP assist | $7.41 | $9.12 | $21.88 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $37.15 Median $39.81 Typical High $93.33 | Professional | TC · Technical part | $37.15 | $39.81 | $93.33 |
Where South Carolina sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 51st of 51
$46.77
MT $93.33SC $46.77
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.