How much rates vary
Facilitymedian $4 · 10th to 90th $3 to $6Professionalmedian $4 · 10th to 90th $3 to $6
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 $2.82 Median $2.82 Typical High $2.82 | Facility | None | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2.82 Median $2.82 Typical High $3.98 | Professional | None (both parts) | $2.82 | $2.82 | $3.98 |
BCBS South Carolina Setting Facility Modifier None Typical Low $5.75 Median $6.46 Typical High $6.46 | Facility | None | $5.75 | $6.46 | $6.46 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None (both parts) | $6.46 | $6.46 | $6.46 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Professional Modifier None (both parts) Typical Low $2.95 Median $2.95 Typical High $3.80 | Professional | None (both parts) | $2.95 | $2.95 | $3.80 |
Medcost Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
Medcost Setting Facility Modifier None Typical Low $1.82 Median $3.09 Typical High $7.76 | Facility | None | $1.82 | $3.09 | $7.76 |
Medcost Setting Professional Modifier None (both parts) Typical Low $3.98 Median $4.47 Typical High $8.51 | Professional | None (both parts) | $3.98 | $4.47 | $8.51 |
Molina Setting Professional Modifier None (both parts) Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None (both parts) | $4.27 | $4.27 | $4.27 |
United Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
United Setting Professional Modifier None (both parts) Typical Low $2.34 Median $3.16 Typical High $4.27 | Professional | None (both parts) | $2.34 | $3.16 | $4.27 |
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 $1.41 Median $1.41 Typical High $2.00 | Professional | 52 · Reduced service | $1.41 | $1.41 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.56 Typical High $0.79 | Professional | 53 · Discontinued | $0.56 | $0.56 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.42 Typical High $0.60 | Professional | 55 · Aftercare only | $0.42 | $0.42 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.40 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1.78 Median $1.91 Typical High $4.47 | Professional | 26 · Professional part | $1.78 | $1.91 | $4.47 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $6.03 Median $7.08 Typical High $16.98 | Professional | 50 · Both sides | $6.03 | $7.08 | $16.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.00 Median $2.34 Typical High $5.62 | Professional | 51 · Multiple procedures | $2.00 | $2.34 | $5.62 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $0.79 Median $0.93 Typical High $2.24 | Professional | 80 · Assistant surgeon | $0.79 | $0.93 | $2.24 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.56 Median $0.66 Typical High $1.58 | Professional | 81 · Minimal assistant surgeon | $0.56 | $0.66 | $1.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.56 Median $0.66 Typical High $1.58 | Professional | 82 · Assistant surgeon, no resident | $0.56 | $0.66 | $1.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.56 Median $0.66 Typical High $1.58 | Professional | AS · PA/NP assist | $0.56 | $0.66 | $1.58 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $2.63 Median $2.82 Typical High $6.76 | Professional | TC · Technical part | $2.63 | $2.82 | $6.76 |
Where South Carolina sits
The same service costs 4.9 times more in Kansas 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· 19th of 51
$4.27
KS $14.45DE $2.95
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.