How much rates vary
Facilitymedian $759 · 10th to 90th $447 to $1,023Professionalmedian $589 · 10th to 90th $302 to $1,023
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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None (both parts) Typical Low $446.68 Median $446.68 Typical High $794.33 | Professional | None (both parts) | $446.68 | $446.68 | $794.33 |
BCBS South Carolina Setting Facility Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,023.29 | Facility | None | $933.25 | $1,023.29 | $1,023.29 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $302.00 Median $489.78 Typical High $1,023.29 | Professional | None (both parts) | $302.00 | $489.78 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None (both parts) Typical Low $549.54 Median $549.54 Typical High $758.58 | Professional | None (both parts) | $549.54 | $549.54 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $251.19 Median $489.78 Typical High $1,230.27 | Facility | None | $251.19 | $489.78 | $1,230.27 |
Medcost Setting Professional Modifier None (both parts) Typical Low $977.24 Median $977.24 Typical High $1,202.26 | Professional | None (both parts) | $977.24 | $977.24 | $1,202.26 |
Molina Setting Professional Modifier None (both parts) Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None (both parts) | $831.76 | $831.76 | $831.76 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
United Setting Professional Modifier None (both parts) Typical Low $416.87 Median $616.60 Typical High $831.76 | Professional | None (both parts) | $416.87 | $616.60 | $831.76 |
13 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 $223.87 Median $223.87 Typical High $295.12 | Professional | 52 · Reduced service | $223.87 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $117.49 | Professional | 53 · Discontinued | $89.13 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $89.13 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $58.88 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $58.88 |
Ambetter Setting Professional Modifier CG · Policy criteria applied Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | CG · Policy criteria applied | $870.96 | $870.96 | $870.96 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $389.05 Median $389.05 Typical High $645.65 | Professional | 26 · Professional part | $389.05 | $389.05 | $645.65 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,445.44 Typical High $2,398.83 | Professional | 50 · Both sides | $1,445.44 | $1,445.44 | $2,398.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $489.78 Typical High $794.33 | Professional | 51 · Multiple procedures | $489.78 | $489.78 | $794.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $194.98 Typical High $323.59 | Professional | 80 · Assistant surgeon | $194.98 | $194.98 | $323.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $134.90 Median $134.90 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $134.90 | $134.90 | $223.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $134.90 Median $134.90 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $134.90 | $134.90 | $223.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $134.90 Typical High $223.87 | Professional | AS · PA/NP assist | $134.90 | $134.90 | $223.87 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $588.84 Median $588.84 Typical High $954.99 | Professional | TC · Technical part | $588.84 | $588.84 | $954.99 |
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· 40th of 51
$589
HI $1,230UT $479
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.