How much rates vary
Facilitymedian $126 · 10th to 90th $100 to $251Professionalmedian $141 · 10th to 90th $95 to $251
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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None (both parts) Typical Low $117.49 Median $120.23 Typical High $147.91 | Professional | None (both parts) | $117.49 | $120.23 | $147.91 |
BCBS South Carolina Setting Facility Modifier None Typical Low $223.87 Median $251.19 Typical High $251.19 | Facility | None | $223.87 | $251.19 | $251.19 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $141.25 Median $204.17 Typical High $251.19 | Professional | None (both parts) | $141.25 | $204.17 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None (both parts) Typical Low $91.20 Median $91.20 Typical High $147.91 | Professional | None (both parts) | $91.20 | $91.20 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $134.90 | Professional | None | $91.20 | $91.20 | $134.90 |
Medcost Setting Facility Modifier None Typical Low $58.88 Median $128.82 Typical High $302.00 | Facility | None | $58.88 | $128.82 | $302.00 |
Medcost Setting Professional Modifier None (both parts) Typical Low $138.04 Median $177.83 Typical High $323.59 | Professional | None (both parts) | $138.04 | $177.83 | $323.59 |
Molina Setting Professional Modifier None (both parts) Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None (both parts) | $165.96 | $165.96 | $165.96 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $251.19 | Facility | None | $87.10 | $100.00 | $251.19 |
United Setting Professional Modifier None (both parts) Typical Low $75.86 Median $117.49 Typical High $147.91 | Professional | None (both parts) | $75.86 | $117.49 | $147.91 |
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 $60.26 Median $60.26 Typical High $74.13 | Professional | 52 · Reduced service | $60.26 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $29.51 | Professional | 53 · Discontinued | $23.99 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $21.88 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $14.79 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $70.79 Median $74.13 Typical High $173.78 | Professional | 26 · Professional part | $70.79 | $74.13 | $173.78 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $263.03 Typical High $645.65 | Professional | 50 · Both sides | $208.93 | $263.03 | $645.65 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $87.10 Typical High $218.78 | Professional | 51 · Multiple procedures | $69.18 | $87.10 | $218.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $27.54 Median $35.48 Typical High $87.10 | Professional | 80 · Assistant surgeon | $27.54 | $35.48 | $87.10 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.50 Median $24.55 Typical High $60.26 | Professional | 81 · Minimal assistant surgeon | $19.50 | $24.55 | $60.26 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.50 Median $24.55 Typical High $60.26 | Professional | 82 · Assistant surgeon, no resident | $19.50 | $24.55 | $60.26 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.50 Median $24.55 Typical High $60.26 | Professional | AS · PA/NP assist | $19.50 | $24.55 | $60.26 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $104.71 Median $109.65 Typical High $263.03 | Professional | TC · Technical part | $104.71 | $109.65 | $263.03 |
Where South Carolina sits
The same service costs 2.4 times more in Hawaii 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
$141
HI $219DE $91.20
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.