How much rates vary
Facilitymedian $135 · 10th to 90th $120 to $275Professionalmedian $155 · 10th to 90th $105 to $275
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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $131.83 Median $131.83 Typical High $162.18 | Professional | None (both parts) | $131.83 | $131.83 | $162.18 |
BCBS South Carolina Setting Facility Modifier None Typical Low $245.47 Median $275.42 Typical High $275.42 | Facility | None | $245.47 | $275.42 | $275.42 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $154.88 Median $223.87 Typical High $275.42 | Professional | None (both parts) | $154.88 | $223.87 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None (both parts) Typical Low $100.00 Median $100.00 Typical High $162.18 | Professional | None (both parts) | $100.00 | $100.00 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $120.23 | Professional | None | $112.20 | $112.20 | $120.23 |
Medcost Setting Facility Modifier None Typical Low $64.57 Median $141.25 Typical High $331.13 | Facility | None | $64.57 | $141.25 | $331.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $151.36 Median $194.98 Typical High $354.81 | Professional | None (both parts) | $151.36 | $194.98 | $354.81 |
Molina Setting Professional Modifier None (both parts) Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None (both parts) | $181.97 | $181.97 | $181.97 |
United Setting Facility Modifier None Typical Low $63.10 Median $128.82 Typical High $275.42 | Facility | None | $63.10 | $128.82 | $275.42 |
United Setting Professional Modifier None (both parts) Typical Low $83.18 Median $128.82 Typical High $162.18 | Professional | None (both parts) | $83.18 | $128.82 | $162.18 |
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 $66.07 Median $66.07 Typical High $81.28 | Professional | 52 · Reduced service | $66.07 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $32.36 | Professional | 53 · Discontinued | $26.92 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $23.99 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $16.22 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $16.22 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $77.62 Median $81.28 Typical High $190.55 | Professional | 26 · Professional part | $77.62 | $81.28 | $190.55 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $288.40 Typical High $707.95 | Professional | 50 · Both sides | $229.09 | $288.40 | $707.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $95.50 Typical High $239.88 | Professional | 51 · Multiple procedures | $75.86 | $95.50 | $239.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.20 Median $38.90 Typical High $95.50 | Professional | 80 · Assistant surgeon | $30.20 | $38.90 | $95.50 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.38 Median $26.92 Typical High $66.07 | Professional | 81 · Minimal assistant surgeon | $21.38 | $26.92 | $66.07 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.38 Median $26.92 Typical High $66.07 | Professional | 82 · Assistant surgeon, no resident | $21.38 | $26.92 | $66.07 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $21.38 Median $26.92 Typical High $66.07 | Professional | AS · PA/NP assist | $21.38 | $26.92 | $66.07 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $114.82 Median $120.23 Typical High $288.40 | Professional | TC · Technical part | $114.82 | $120.23 | $288.40 |
Where South Carolina sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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· 19th of 51
$155
KS $389NJ $100
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.