How much rates vary
Facilitymedian $135 · 10th to 90th $123 to $468Professionalmedian $132 · 10th to 90th $98 to $166
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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | None (both parts) | $123.03 | $128.82 | $128.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $269.15 Median $389.05 Typical High $512.86 | Facility | None | $269.15 | $389.05 | $512.86 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $97.72 Median $131.83 Typical High $141.25 | Professional | None (both parts) | $97.72 | $131.83 | $141.25 |
Cigna Setting Professional Modifier None (both parts) Typical Low $131.83 Median $147.91 Typical High $173.78 | Professional | None (both parts) | $131.83 | $147.91 | $173.78 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $134.90 Typical High $338.84 | Facility | None | $109.65 | $134.90 | $338.84 |
Medcost Setting Professional Modifier None (both parts) Typical Low $128.82 Median $144.54 Typical High $165.96 | Professional | None (both parts) | $128.82 | $144.54 | $165.96 |
Molina Setting Professional Modifier None (both parts) Typical Low $120.23 Median $162.18 Typical High $251.19 | Professional | None (both parts) | $120.23 | $162.18 | $251.19 |
United Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $134.90 | Facility | None | $123.03 | $123.03 | $134.90 |
United Setting Professional Modifier None (both parts) Typical Low $102.33 Median $125.89 Typical High $186.21 | Professional | None (both parts) | $102.33 | $125.89 | $186.21 |
11 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 $60.26 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $60.26 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $24.55 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.30 | $12.88 | $12.88 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $52.48 Median $63.10 Typical High $83.18 | Professional | 26 · Professional part | $52.48 | $63.10 | $83.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $66.07 Median $77.62 Typical High $89.13 | Professional | 51 · Multiple procedures | $66.07 | $77.62 | $89.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.30 Median $31.62 Typical High $35.48 | Professional | 80 · Assistant surgeon | $26.30 | $31.62 | $35.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $18.62 Median $21.88 Typical High $25.12 | Professional | 81 · Minimal assistant surgeon | $18.62 | $21.88 | $25.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $18.62 Median $21.88 Typical High $25.12 | Professional | 82 · Assistant surgeon, no resident | $18.62 | $21.88 | $25.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $18.62 Median $21.88 Typical High $25.12 | Professional | AS · PA/NP assist | $18.62 | $21.88 | $25.12 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $79.43 Median $93.33 Typical High $125.89 | Professional | TC · Technical part | $79.43 | $93.33 | $125.89 |
Where South Carolina sits
The same service costs 2.8 times more in Alaska than in Indiana. 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· 33rd of 51
$132
AK $269IN $95.50
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.