How much rates vary
Facilitymedian $417 · 10th to 90th $316 to $646Professionalmedian $363 · 10th to 90th $302 to $646
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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None (both parts) Typical Low $316.23 Median $316.23 Typical High $380.19 | Professional | None (both parts) | $316.23 | $316.23 | $380.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $575.44 Median $645.65 Typical High $645.65 | Facility | None | $575.44 | $645.65 | $645.65 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $363.08 Median $524.81 Typical High $645.65 | Professional | None (both parts) | $363.08 | $524.81 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None (both parts) Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None (both parts) | $309.03 | $309.03 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $338.84 | Professional | None | $302.00 | $302.00 | $338.84 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $346.74 Typical High $776.25 | Facility | None | $177.83 | $346.74 | $776.25 |
Medcost Setting Professional Modifier None (both parts) Typical Low $354.81 Median $457.09 Typical High $851.14 | Professional | None (both parts) | $354.81 | $457.09 | $851.14 |
United Setting Facility Modifier None Typical Low $363.08 Median $371.54 Typical High $758.58 | Facility | None | $363.08 | $371.54 | $758.58 |
United Setting Professional Modifier None (both parts) Typical Low $213.80 Median $309.03 Typical High $380.19 | Professional | None (both parts) | $213.80 | $309.03 | $380.19 |
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 $158.49 Median $158.49 Typical High $190.55 | Professional | 52 · Reduced service | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | 53 · Discontinued | $63.10 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $57.54 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $38.02 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $38.02 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $181.97 Median $190.55 Typical High $446.68 | Professional | 26 · Professional part | $181.97 | $190.55 | $446.68 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $676.08 Typical High $1,698.24 | Professional | 50 · Both sides | $537.03 | $676.08 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $229.09 Typical High $562.34 | Professional | 51 · Multiple procedures | $177.83 | $229.09 | $562.34 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $91.20 Typical High $223.87 | Professional | 80 · Assistant surgeon | $70.79 | $91.20 | $223.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $63.10 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $50.12 | $63.10 | $158.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $63.10 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $63.10 | $158.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $63.10 Typical High $158.49 | Professional | AS · PA/NP assist | $50.12 | $63.10 | $158.49 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $275.42 Median $288.40 Typical High $676.08 | Professional | TC · Technical part | $275.42 | $288.40 | $676.08 |
Where South Carolina sits
The same service costs 2.9 times more in Hawaii than in Washington, DC. 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· 27th of 51
$363
HI $871DC $302
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.