How much rates vary
Facilitymedian $44 · 10th to 90th $34 to $93Professionalmedian $54 · 10th to 90th $34 to $78
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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None (both parts) Typical Low $33.88 Median $33.88 Typical High $47.86 | Professional | None (both parts) | $33.88 | $33.88 | $47.86 |
BCBS South Carolina Setting Facility Modifier None Typical Low $70.79 Median $77.62 Typical High $77.62 | Facility | None | $70.79 | $77.62 | $77.62 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None (both parts) | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $46.77 | Facility | None | $43.65 | $43.65 | $46.77 |
Cigna Setting Professional Modifier None (both parts) Typical Low $37.15 Median $37.15 Typical High $45.71 | Professional | None (both parts) | $37.15 | $37.15 | $45.71 |
Medcost Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medcost Setting Facility Modifier None Typical Low $21.88 Median $38.02 Typical High $95.50 | Facility | None | $21.88 | $38.02 | $95.50 |
Medcost Setting Professional Modifier None (both parts) Typical Low $53.70 Median $53.70 Typical High $102.33 | Professional | None (both parts) | $53.70 | $53.70 | $102.33 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None (both parts) Typical Low $28.18 Median $38.02 Typical High $51.29 | Professional | None (both parts) | $28.18 | $38.02 | $51.29 |
10 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 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $7.24 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $4.79 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $21.38 Median $22.91 Typical High $53.70 | Professional | 26 · Professional part | $21.38 | $22.91 | $53.70 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $81.28 Median $85.11 Typical High $204.17 | Professional | 50 · Both sides | $81.28 | $85.11 | $204.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.92 Median $28.18 Typical High $67.61 | Professional | 51 · Multiple procedures | $26.92 | $28.18 | $67.61 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.72 Median $11.48 Typical High $26.92 | Professional | 80 · Assistant surgeon | $10.72 | $11.48 | $26.92 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.59 Median $7.94 Typical High $19.05 | Professional | 81 · Minimal assistant surgeon | $7.59 | $7.94 | $19.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.59 Median $7.94 Typical High $19.05 | Professional | 82 · Assistant surgeon, no resident | $7.59 | $7.94 | $19.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.59 Median $7.94 Typical High $19.05 | Professional | AS · PA/NP assist | $7.59 | $7.94 | $19.05 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $32.36 Median $34.67 Typical High $81.28 | Professional | TC · Technical part | $32.36 | $34.67 | $81.28 |
Where South Carolina sits
The same service costs 2.2 times more in Montana than in West Virginia. 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· 20th of 51
$52.48
MT $81.28WV $37.15
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.