How much rates vary
Facilitymedian $398 · 10th to 90th $316 to $661Professionalmedian $372 · 10th to 90th $295 to $661
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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None (both parts) Typical Low $316.23 Median $316.23 Typical High $398.11 | Professional | None (both parts) | $316.23 | $316.23 | $398.11 |
BCBS South Carolina Setting Facility Modifier None Typical Low $588.84 Median $660.69 Typical High $660.69 | Facility | None | $588.84 | $660.69 | $660.69 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $371.54 Median $537.03 Typical High $660.69 | Professional | None (both parts) | $371.54 | $537.03 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None (both parts) | $295.12 | $295.12 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $436.52 | Professional | None | $323.59 | $323.59 | $436.52 |
Medcost Setting Facility Modifier None Typical Low $204.17 Median $363.08 Typical High $794.33 | Facility | None | $204.17 | $363.08 | $794.33 |
Medcost Setting Professional Modifier None (both parts) Typical Low $363.08 Median $457.09 Typical High $851.14 | Professional | None (both parts) | $363.08 | $457.09 | $851.14 |
Molina Setting Professional Modifier None (both parts) Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None (both parts) | $436.52 | $436.52 | $436.52 |
United Setting Facility Modifier None Typical Low $295.12 Median $331.13 Typical High $870.96 | Facility | None | $295.12 | $331.13 | $870.96 |
United Setting Professional Modifier None (both parts) Typical Low $245.47 Median $316.23 Typical High $398.11 | Professional | None (both parts) | $245.47 | $316.23 | $398.11 |
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 $158.49 Median $158.49 Typical High $199.53 | Professional | 52 · Reduced service | $158.49 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $79.43 | Professional | 53 · Discontinued | $63.10 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $58.88 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $39.81 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $39.81 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $181.97 Median $190.55 Typical High $457.09 | Professional | 26 · Professional part | $181.97 | $190.55 | $457.09 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $691.83 Typical High $1,698.24 | Professional | 50 · Both sides | $537.03 | $691.83 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $229.09 Typical High $562.34 | Professional | 51 · Multiple procedures | $181.97 | $229.09 | $562.34 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $91.20 Typical High $229.09 | Professional | 80 · Assistant surgeon | $72.44 | $91.20 | $229.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $64.57 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $50.12 | $64.57 | $158.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $64.57 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $64.57 | $158.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $64.57 Typical High $158.49 | Professional | AS · PA/NP assist | $50.12 | $64.57 | $158.49 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $275.42 Median $288.40 Typical High $676.08 | Professional | TC · Technical part | $275.42 | $288.40 | $676.08 |
Where South Carolina sits
The same service costs 3.0 times more in Montana 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· 40th of 51
$372
MT $871FL $295
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.