How much rates vary
Facilitymedian $316 · 10th to 90th $209 to $427Professionalmedian $245 · 10th to 90th $209 to $427
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 $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None (both parts) Typical Low $208.93 Median $208.93 Typical High $288.40 | Professional | None (both parts) | $208.93 | $208.93 | $288.40 |
BCBS South Carolina Setting Facility Modifier None Typical Low $389.05 Median $426.58 Typical High $426.58 | Facility | None | $389.05 | $426.58 | $426.58 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $245.47 Median $346.74 Typical High $426.58 | Professional | None (both parts) | $245.47 | $346.74 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $346.74 | Facility | None | $316.23 | $316.23 | $346.74 |
Cigna Setting Professional Modifier None (both parts) Typical Low $229.09 Median $229.09 Typical High $346.74 | Professional | None (both parts) | $229.09 | $229.09 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $257.04 | Professional | None | $234.42 | $234.42 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $134.90 Median $234.42 Typical High $524.81 | Facility | None | $134.90 | $234.42 | $524.81 |
Medcost Setting Professional Modifier None (both parts) Typical Low $234.42 Median $302.00 Typical High $562.34 | Professional | None (both parts) | $234.42 | $302.00 | $562.34 |
United Setting Facility Modifier None Typical Low $245.47 Median $269.15 Typical High $562.34 | Facility | None | $245.47 | $269.15 | $562.34 |
United Setting Professional Modifier None (both parts) Typical Low $162.18 Median $208.93 Typical High $263.03 | Professional | None (both parts) | $162.18 | $208.93 | $263.03 |
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 $104.71 Median $104.71 Typical High $128.82 | Professional | 52 · Reduced service | $104.71 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $52.48 | Professional | 53 · Discontinued | $41.69 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $38.90 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $25.70 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $25.70 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $120.23 Median $125.89 Typical High $295.12 | Professional | 26 · Professional part | $120.23 | $125.89 | $295.12 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $457.09 Typical High $1,122.02 | Professional | 50 · Both sides | $354.81 | $457.09 | $1,122.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $117.49 Median $151.36 Typical High $371.54 | Professional | 51 · Multiple procedures | $117.49 | $151.36 | $371.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $60.26 Typical High $147.91 | Professional | 80 · Assistant surgeon | $47.86 | $60.26 | $147.91 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.11 Median $42.66 Typical High $104.71 | Professional | 81 · Minimal assistant surgeon | $33.11 | $42.66 | $104.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.11 Median $42.66 Typical High $104.71 | Professional | 82 · Assistant surgeon, no resident | $33.11 | $42.66 | $104.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $42.66 Typical High $104.71 | Professional | AS · PA/NP assist | $33.11 | $42.66 | $104.71 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $181.97 Median $190.55 Typical High $446.68 | Professional | TC · Technical part | $181.97 | $190.55 | $446.68 |
Where South Carolina sits
The same service costs 2.6 times more in Hawaii than in Arizona. 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· 41st of 51
$245
HI $589AZ $229
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.