How much rates vary
Facilitymedian $813 · 10th to 90th $550 to $1,288Professionalmedian $741 · 10th to 90th $302 to $1,288
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 $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $549.54 Median $549.54 Typical High $870.96 | Professional | None (both parts) | $549.54 | $549.54 | $870.96 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None (both parts) | $741.31 | $741.31 | $741.31 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,174.90 | $1,288.25 | $1,288.25 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $302.00 Median $426.58 Typical High $1,288.25 | Professional | None (both parts) | $302.00 | $426.58 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Facility | None | $812.83 | $812.83 | $954.99 |
Cigna Setting Professional Modifier None (both parts) Typical Low $588.84 Median $588.84 Typical High $954.99 | Professional | None (both parts) | $588.84 | $588.84 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $602.56 Typical High $1,479.11 | Facility | None | $288.40 | $602.56 | $1,479.11 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,258.93 Median $1,288.25 Typical High $1,479.11 | Professional | None (both parts) | $1,258.93 | $1,288.25 | $1,479.11 |
Molina Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None (both parts) | $1,122.02 | $1,122.02 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
United Setting Professional Modifier None (both parts) Typical Low $489.78 Median $776.25 Typical High $1,047.13 | Professional | None (both parts) | $489.78 | $776.25 | $1,047.13 |
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 $269.15 Median $269.15 Typical High $363.08 | Professional | 52 · Reduced service | $269.15 | $269.15 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $144.54 | Professional | 53 · Discontinued | $109.65 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $107.15 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $72.44 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $72.44 |
Cigna Setting Professional Modifier RR · Rental Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | RR · Rental | $69.18 | $69.18 | $81.28 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $512.86 Median $512.86 Typical High $776.25 | Professional | 26 · Professional part | $512.86 | $512.86 | $776.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $1,949.84 Typical High $3,090.30 | Professional | 50 · Both sides | $1,949.84 | $1,949.84 | $3,090.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $645.65 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $645.65 | $645.65 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $257.04 Typical High $416.87 | Professional | 80 · Assistant surgeon | $257.04 | $257.04 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $181.97 Median $181.97 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $181.97 | $181.97 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $181.97 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $181.97 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $181.97 Typical High $288.40 | Professional | AS · PA/NP assist | $181.97 | $181.97 | $288.40 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $776.25 Median $776.25 Typical High $1,174.90 | Professional | TC · Technical part | $776.25 | $776.25 | $1,174.90 |
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· 30th of 51
$741
HI $1,445UT $550
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.