How much rates vary
Facilitymedian $0 · 10th to 90th $0 to $1Professionalmedian $1 · 10th to 90th $0 to $1
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 $0.33 Median $0.33 Typical High $0.33 | Facility | None | $0.33 | $0.33 | $0.33 |
Aetna Setting Professional Modifier None (both parts) Typical Low $0.33 Median $0.33 Typical High $0.47 | Professional | None (both parts) | $0.33 | $0.33 | $0.47 |
BCBS South Carolina Setting Facility Modifier None Typical Low $0.69 Median $0.78 Typical High $0.78 | Facility | None | $0.69 | $0.78 | $0.78 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $0.50 Median $0.69 Typical High $0.78 | Professional | None (both parts) | $0.50 | $0.69 | $0.78 |
Cigna Setting Facility Modifier None Typical Low $0.42 Median $0.42 Typical High $0.45 | Facility | None | $0.42 | $0.42 | $0.45 |
Cigna Setting Professional Modifier None (both parts) Typical Low $0.36 Median $0.36 Typical High $0.45 | Professional | None (both parts) | $0.36 | $0.36 | $0.45 |
Medcost Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | None | $0.37 | $0.37 | $0.37 |
Medcost Setting Facility Modifier None Typical Low $0.22 Median $0.36 Typical High $0.91 | Facility | None | $0.22 | $0.36 | $0.91 |
Medcost Setting Professional Modifier None (both parts) Typical Low $0.52 Median $0.52 Typical High $1.00 | Professional | None (both parts) | $0.52 | $0.52 | $1.00 |
Molina Setting Professional Modifier None (both parts) Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | None (both parts) | $0.50 | $0.50 | $0.50 |
United Setting Facility Modifier None Typical Low $0.91 Median $0.91 Typical High $0.91 | Facility | None | $0.91 | $0.91 | $0.91 |
United Setting Professional Modifier None (both parts) Typical Low $0.28 Median $0.37 Typical High $0.50 | Professional | None (both parts) | $0.28 | $0.37 | $0.50 |
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 $0.17 Median $0.17 Typical High $0.24 | Professional | 52 · Reduced service | $0.17 | $0.17 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.09 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.07 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.05 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $0.21 Median $0.22 Typical High $0.52 | Professional | 26 · Professional part | $0.21 | $0.22 | $0.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $0.79 Median $0.83 Typical High $2.00 | Professional | 50 · Both sides | $0.79 | $0.83 | $2.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.26 Median $0.28 Typical High $0.66 | Professional | 51 · Multiple procedures | $0.26 | $0.28 | $0.66 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $0.10 Median $0.11 Typical High $0.26 | Professional | 80 · Assistant surgeon | $0.10 | $0.11 | $0.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.07 Median $0.08 Typical High $0.18 | Professional | 81 · Minimal assistant surgeon | $0.07 | $0.08 | $0.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.07 Median $0.08 Typical High $0.18 | Professional | 82 · Assistant surgeon, no resident | $0.07 | $0.08 | $0.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.07 Median $0.08 Typical High $0.18 | Professional | AS · PA/NP assist | $0.07 | $0.08 | $0.18 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $0.32 Median $0.34 Typical High $0.79 | Professional | TC · Technical part | $0.32 | $0.34 | $0.79 |
Where South Carolina sits
The same service costs 2.3 times more in Montana than in Hawaii. 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· 29th of 51
$0.50
MT $0.81HI $0.35
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.