How much rates vary
Facilitymedian $191 · 10th to 90th $145 to $302Professionalmedian $170 · 10th to 90th $138 to $302
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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $144.54 Median $144.54 Typical High $177.83 | Professional | None (both parts) | $144.54 | $144.54 | $177.83 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $229.09 Median $229.09 Typical High $302.00 | Professional | None (both parts) | $229.09 | $229.09 | $302.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $269.15 Median $302.00 Typical High $302.00 | Facility | None | $269.15 | $302.00 | $302.00 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $169.82 Median $245.47 Typical High $302.00 | Professional | None (both parts) | $169.82 | $245.47 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None (both parts) Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None (both parts) | $138.04 | $138.04 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | None | $147.91 | $147.91 | $177.83 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $165.96 Typical High $363.08 | Facility | None | $95.50 | $165.96 | $363.08 |
Medcost Setting Professional Modifier None (both parts) Typical Low $165.96 Median $213.80 Typical High $389.05 | Professional | None (both parts) | $165.96 | $213.80 | $389.05 |
Molina Setting Professional Modifier None (both parts) Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None (both parts) | $199.53 | $199.53 | $199.53 |
United Setting Facility Modifier None Typical Low $190.55 Median $194.98 Typical High $398.11 | Facility | None | $190.55 | $194.98 | $398.11 |
United Setting Professional Modifier None (both parts) Typical Low $112.20 Median $147.91 Typical High $186.21 | Professional | None (both parts) | $112.20 | $147.91 | $186.21 |
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 $72.44 Median $72.44 Typical High $89.13 | Professional | 52 · Reduced service | $72.44 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $35.48 | Professional | 53 · Discontinued | $29.51 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $26.30 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $17.78 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $85.11 Median $89.13 Typical High $208.93 | Professional | 26 · Professional part | $85.11 | $89.13 | $208.93 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $251.19 Median $316.23 Typical High $776.25 | Professional | 50 · Both sides | $251.19 | $316.23 | $776.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $107.15 Typical High $263.03 | Professional | 51 · Multiple procedures | $83.18 | $107.15 | $263.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.11 Median $42.66 Typical High $104.71 | Professional | 80 · Assistant surgeon | $33.11 | $42.66 | $104.71 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.44 Median $29.51 Typical High $72.44 | Professional | 81 · Minimal assistant surgeon | $23.44 | $29.51 | $72.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.44 Median $29.51 Typical High $72.44 | Professional | 82 · Assistant surgeon, no resident | $23.44 | $29.51 | $72.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $23.44 Median $29.51 Typical High $72.44 | Professional | AS · PA/NP assist | $23.44 | $29.51 | $72.44 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $125.89 Median $131.83 Typical High $316.23 | Professional | TC · Technical part | $125.89 | $131.83 | $316.23 |
Where South Carolina sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 39th of 51
$170
HI $479FL $138
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.