How much rates vary
Facilitymedian $457 · 10th to 90th $407 to $933Professionalmedian $525 · 10th to 90th $355 to $933
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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None (both parts) Typical Low $407.38 Median $457.09 Typical High $676.08 | Professional | None (both parts) | $407.38 | $457.09 | $676.08 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None (both parts) | $1,348.96 | $1,348.96 | $1,348.96 |
BCBS South Carolina Setting Facility Modifier None Typical Low $141.25 Median $831.76 Typical High $933.25 | Facility | None | $141.25 | $831.76 | $933.25 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $524.81 Median $758.58 Typical High $933.25 | Professional | None (both parts) | $524.81 | $758.58 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Professional Modifier None (both parts) Typical Low $338.84 Median $338.84 Typical High $549.54 | Professional | None (both parts) | $338.84 | $338.84 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $478.63 | Professional | None | $346.74 | $346.74 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $478.63 Typical High $1,122.02 | Facility | None | $218.78 | $478.63 | $1,122.02 |
Medcost Setting Professional Modifier None (both parts) Typical Low $489.78 Median $645.65 Typical High $1,230.27 | Professional | None (both parts) | $489.78 | $645.65 | $1,230.27 |
Molina Setting Professional Modifier None (both parts) Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None (both parts) | $616.60 | $616.60 | $616.60 |
United Setting Facility Modifier None Typical Low $407.38 Median $933.25 Typical High $933.25 | Facility | None | $407.38 | $933.25 | $933.25 |
United Setting Professional Modifier None (both parts) Typical Low $281.84 Median $436.52 Typical High $549.54 | Professional | None (both parts) | $281.84 | $436.52 | $549.54 |
13 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 $223.87 Median $223.87 Typical High $275.42 | Professional | 52 · Reduced service | $223.87 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | 53 · Discontinued | $91.20 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $54.95 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $54.95 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $194.98 Median $275.42 Typical High $645.65 | Professional | 26 · Professional part | $194.98 | $275.42 | $645.65 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $977.24 Typical High $2,398.83 | Professional | 50 · Both sides | $724.44 | $977.24 | $2,398.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $245.47 Median $338.84 Typical High $812.83 | Professional | 51 · Multiple procedures | $245.47 | $338.84 | $812.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $131.83 Typical High $323.59 | Professional | 80 · Assistant surgeon | $97.72 | $131.83 | $323.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $67.61 Median $91.20 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $67.61 | $91.20 | $223.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $67.61 Median $91.20 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $67.61 | $91.20 | $223.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $91.20 Typical High $223.87 | Professional | AS · PA/NP assist | $67.61 | $91.20 | $223.87 |
Medcost Setting Professional Modifier RR · Rental Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | RR · Rental | $51.29 | $51.29 | $51.29 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $295.12 Median $407.38 Typical High $977.24 | Professional | TC · Technical part | $295.12 | $407.38 | $977.24 |
Where South Carolina sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. 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· 22nd of 51
$525
HI $871NH $339
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.