How much rates vary
Facilitymedian $708 · 10th to 90th $550 to $1,148Professionalmedian $646 · 10th to 90th $513 to $1,148
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 $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $549.54 Median $549.54 Typical High $707.95 | Professional | None (both parts) | $549.54 | $549.54 | $707.95 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $933.25 Median $1,023.29 Typical High $1,023.29 | Professional | None (both parts) | $933.25 | $1,023.29 | $1,023.29 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,023.29 | $1,148.15 | $1,148.15 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $645.65 Median $933.25 Typical High $1,148.15 | Professional | None (both parts) | $645.65 | $933.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $776.25 | Facility | None | $707.95 | $707.95 | $776.25 |
Cigna Setting Professional Modifier None (both parts) Typical Low $512.86 Median $512.86 Typical High $776.25 | Professional | None (both parts) | $512.86 | $512.86 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $776.25 | Professional | None | $512.86 | $512.86 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $616.60 Typical High $1,380.38 | Facility | None | $331.13 | $616.60 | $1,380.38 |
Medcost Setting Professional Modifier None (both parts) Typical Low $630.96 Median $812.83 Typical High $1,479.11 | Professional | None (both parts) | $630.96 | $812.83 | $1,479.11 |
Molina Setting Professional Modifier None (both parts) Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None (both parts) | $758.58 | $758.58 | $758.58 |
United Setting Facility Modifier None Typical Low $478.63 Median $691.83 Typical High $1,412.54 | Facility | None | $478.63 | $691.83 | $1,412.54 |
United Setting Professional Modifier None (both parts) Typical Low $398.11 Median $549.54 Typical High $691.83 | Professional | None (both parts) | $398.11 | $549.54 | $691.83 |
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 $275.42 Median $275.42 Typical High $338.84 | Professional | 52 · Reduced service | $275.42 | $275.42 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $134.90 | Professional | 53 · Discontinued | $112.20 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $67.61 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $67.61 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $323.59 Median $338.84 Typical High $794.33 | Professional | 26 · Professional part | $323.59 | $338.84 | $794.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,202.26 Typical High $2,951.21 | Professional | 50 · Both sides | $954.99 | $1,202.26 | $2,951.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $398.11 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $316.23 | $398.11 | $1,000.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $162.18 Typical High $398.11 | Professional | 80 · Assistant surgeon | $125.89 | $162.18 | $398.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $89.13 Median $112.20 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $89.13 | $112.20 | $275.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $89.13 Median $112.20 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $89.13 | $112.20 | $275.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $112.20 Typical High $275.42 | Professional | AS · PA/NP assist | $89.13 | $112.20 | $275.42 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $478.63 Median $501.19 Typical High $1,202.26 | Professional | TC · Technical part | $478.63 | $501.19 | $1,202.26 |
Where South Carolina sits
The same service costs 3.4 times more in Hawaii than in Mississippi. 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
$646
HI $1,738MS $513
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.