How much rates vary
Facilitymedian $224 · 10th to 90th $151 to $316Professionalmedian $178 · 10th to 90th $148 to $316
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 $190.55 | Professional | None (both parts) | $151.36 | $151.36 | $190.55 |
BCBS South Carolina Setting Facility Modifier None Typical Low $281.84 Median $316.23 Typical High $316.23 | Facility | None | $281.84 | $316.23 | $316.23 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $177.83 Median $257.04 Typical High $316.23 | Professional | None (both parts) | $177.83 | $257.04 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Professional Modifier None (both parts) Typical Low $165.96 Median $165.96 Typical High $223.87 | Professional | None (both parts) | $165.96 | $165.96 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $173.78 | Professional | None | $144.54 | $144.54 | $173.78 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $181.97 Typical High $380.19 | Facility | None | $93.33 | $181.97 | $380.19 |
Medcost Setting Professional Modifier None (both parts) Typical Low $173.78 Median $223.87 Typical High $407.38 | Professional | None (both parts) | $173.78 | $223.87 | $407.38 |
Molina Setting Professional Modifier None (both parts) Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None (both parts) | $208.93 | $208.93 | $208.93 |
United Setting Facility Modifier None Typical Low $190.55 Median $208.93 Typical High $389.05 | Facility | None | $190.55 | $208.93 | $389.05 |
United Setting Professional Modifier None (both parts) Typical Low $109.65 Median $151.36 Typical High $190.55 | Professional | None (both parts) | $109.65 | $151.36 | $190.55 |
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 $95.50 | Professional | 52 · Reduced service | $75.86 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $38.02 | Professional | 53 · Discontinued | $30.90 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $28.84 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $19.05 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $89.13 Median $93.33 Typical High $218.78 | Professional | 26 · Professional part | $89.13 | $93.33 | $218.78 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $263.03 Median $331.13 Typical High $812.83 | Professional | 50 · Both sides | $263.03 | $331.13 | $812.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $87.10 Median $112.20 Typical High $275.42 | Professional | 51 · Multiple procedures | $87.10 | $112.20 | $275.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $34.67 Median $44.67 Typical High $109.65 | Professional | 80 · Assistant surgeon | $34.67 | $44.67 | $109.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $24.55 Median $30.90 Typical High $75.86 | Professional | 81 · Minimal assistant surgeon | $24.55 | $30.90 | $75.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $24.55 Median $30.90 Typical High $75.86 | Professional | 82 · Assistant surgeon, no resident | $24.55 | $30.90 | $75.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $24.55 Median $30.90 Typical High $75.86 | Professional | AS · PA/NP assist | $24.55 | $30.90 | $75.86 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $131.83 Median $138.04 Typical High $331.13 | Professional | TC · Technical part | $131.83 | $138.04 | $331.13 |
Where South Carolina sits
The same service costs 3.4 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· 31st of 51
$178
HI $525DC $155
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.