How much rates vary
Facilitymedian $117 · 10th to 90th $81 to $166Professionalmedian $95 · 10th to 90th $78 to $166
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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None (both parts) Typical Low $81.28 Median $81.28 Typical High $104.71 | Professional | None (both parts) | $81.28 | $81.28 | $104.71 |
BCBS South Carolina Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $165.96 | Facility | None | $147.91 | $165.96 | $165.96 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $95.50 Median $138.04 Typical High $165.96 | Professional | None (both parts) | $95.50 | $138.04 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $125.89 | Facility | None | $117.49 | $117.49 | $125.89 |
Cigna Setting Professional Modifier None (both parts) Typical Low $85.11 Median $85.11 Typical High $125.89 | Professional | None (both parts) | $85.11 | $85.11 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $109.65 | Professional | None | $75.86 | $75.86 | $109.65 |
Medcost Setting Facility Modifier None Typical Low $48.98 Median $89.13 Typical High $199.53 | Facility | None | $48.98 | $89.13 | $199.53 |
Medcost Setting Professional Modifier None (both parts) Typical Low $91.20 Median $117.49 Typical High $218.78 | Professional | None (both parts) | $91.20 | $117.49 | $218.78 |
Molina Setting Professional Modifier None (both parts) Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None (both parts) | $109.65 | $109.65 | $109.65 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $204.17 | Facility | None | $93.33 | $93.33 | $204.17 |
United Setting Professional Modifier None (both parts) Typical Low $57.54 Median $81.28 Typical High $100.00 | Professional | None (both parts) | $57.54 | $81.28 | $100.00 |
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 $40.74 Median $40.74 Typical High $50.12 | Professional | 52 · Reduced service | $40.74 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $19.95 | Professional | 53 · Discontinued | $16.22 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $14.79 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $10.00 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $46.77 Median $48.98 Typical High $114.82 | Professional | 26 · Professional part | $46.77 | $48.98 | $114.82 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $138.04 Median $173.78 Typical High $436.52 | Professional | 50 · Both sides | $138.04 | $173.78 | $436.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $45.71 Median $58.88 Typical High $144.54 | Professional | 51 · Multiple procedures | $45.71 | $58.88 | $144.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.20 Median $23.44 Typical High $57.54 | Professional | 80 · Assistant surgeon | $18.20 | $23.44 | $57.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.88 Median $16.22 Typical High $40.74 | Professional | 81 · Minimal assistant surgeon | $12.88 | $16.22 | $40.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.88 Median $16.22 Typical High $40.74 | Professional | 82 · Assistant surgeon, no resident | $12.88 | $16.22 | $40.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.88 Median $16.22 Typical High $40.74 | Professional | AS · PA/NP assist | $12.88 | $16.22 | $40.74 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $70.79 Median $74.13 Typical High $173.78 | Professional | TC · Technical part | $70.79 | $74.13 | $173.78 |
Where South Carolina sits
The same service costs 2.4 times more in Hawaii than in Colorado. 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· 36th of 51
$95.50
HI $204CO $85.11
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.