How much rates vary
Facilitymedian $275 · 10th to 90th $151 to $347Professionalmedian $219 · 10th to 90th $151 to $347
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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None (both parts) Typical Low $151.36 Median $151.36 Typical High $199.53 | Professional | None (both parts) | $151.36 | $151.36 | $199.53 |
BCBS South Carolina Setting Facility Modifier None Typical Low $316.23 Median $346.74 Typical High $346.74 | Facility | None | $316.23 | $346.74 | $346.74 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $218.78 Median $316.23 Typical High $346.74 | Professional | None (both parts) | $218.78 | $316.23 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Professional Modifier None (both parts) Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None (both parts) | $204.17 | $204.17 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $165.96 Typical High $416.87 | Facility | None | $83.18 | $165.96 | $416.87 |
Medcost Setting Professional Modifier None (both parts) Typical Low $331.13 Median $331.13 Typical High $407.38 | Professional | None (both parts) | $331.13 | $331.13 | $407.38 |
Molina Setting Professional Modifier None (both parts) Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None (both parts) | $281.84 | $281.84 | $281.84 |
United Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
United Setting Professional Modifier None (both parts) Typical Low $141.25 Median $208.93 Typical High $281.84 | Professional | None (both parts) | $141.25 | $208.93 | $281.84 |
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 $75.86 Median $75.86 Typical High $100.00 | Professional | 52 · Reduced service | $75.86 | $75.86 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $39.81 | Professional | 53 · Discontinued | $30.20 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $30.20 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $19.95 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $19.95 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $131.83 Median $131.83 Typical High $218.78 | Professional | 26 · Professional part | $131.83 | $131.83 | $218.78 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $489.78 Typical High $812.83 | Professional | 50 · Both sides | $489.78 | $489.78 | $812.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $165.96 Typical High $269.15 | Professional | 51 · Multiple procedures | $165.96 | $165.96 | $269.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $66.07 Typical High $107.15 | Professional | 80 · Assistant surgeon | $66.07 | $66.07 | $107.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $45.71 Median $45.71 Typical High $75.86 | Professional | 81 · Minimal assistant surgeon | $45.71 | $45.71 | $75.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $45.71 Median $45.71 Typical High $75.86 | Professional | 82 · Assistant surgeon, no resident | $45.71 | $45.71 | $75.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $45.71 Typical High $75.86 | Professional | AS · PA/NP assist | $45.71 | $45.71 | $75.86 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $199.53 Median $199.53 Typical High $323.59 | Professional | TC · Technical part | $199.53 | $199.53 | $323.59 |
Where South Carolina sits
The same service costs 2.6 times more in Hawaii than in Utah. 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
$219
HI $417UT $162
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.