How much rates vary
Facilitymedian $631 · 10th to 90th $407 to $955Professionalmedian $603 · 10th to 90th $407 to $912
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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None (both parts) Typical Low $407.38 Median $407.38 Typical High $707.95 | Professional | None (both parts) | $407.38 | $407.38 | $707.95 |
BCBS South Carolina Setting Facility Modifier None Typical Low $831.76 Median $912.01 Typical High $912.01 | Facility | None | $831.76 | $912.01 | $912.01 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $602.56 Median $831.76 Typical High $912.01 | Professional | None (both parts) | $602.56 | $831.76 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $707.95 | Facility | None | $630.96 | $630.96 | $707.95 |
Cigna Setting Professional Modifier None (both parts) Typical Low $467.74 Median $467.74 Typical High $707.95 | Professional | None (both parts) | $467.74 | $467.74 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $446.68 Typical High $1,096.48 | Facility | None | $407.38 | $446.68 | $1,096.48 |
Medcost Setting Professional Modifier None (both parts) Typical Low $870.96 Median $870.96 Typical High $1,096.48 | Professional | None (both parts) | $870.96 | $870.96 | $1,096.48 |
Molina Setting Professional Modifier None (both parts) Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None (both parts) | $741.31 | $741.31 | $741.31 |
United Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
United Setting Professional Modifier None (both parts) Typical Low $363.08 Median $537.03 Typical High $741.31 | Professional | None (both parts) | $363.08 | $537.03 | $741.31 |
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 $204.17 Median $204.17 Typical High $269.15 | Professional | 52 · Reduced service | $204.17 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $107.15 | Professional | 53 · Discontinued | $81.28 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $81.28 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $53.70 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $53.70 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $346.74 Median $346.74 Typical High $575.44 | Professional | 26 · Professional part | $346.74 | $346.74 | $575.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,288.25 Typical High $2,187.76 | Professional | 50 · Both sides | $1,288.25 | $1,288.25 | $2,187.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $436.52 Typical High $724.44 | Professional | 51 · Multiple procedures | $436.52 | $436.52 | $724.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $173.78 Typical High $288.40 | Professional | 80 · Assistant surgeon | $173.78 | $173.78 | $288.40 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $120.23 Median $120.23 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $120.23 | $120.23 | $204.17 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $120.23 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $120.23 | $204.17 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $120.23 Typical High $204.17 | Professional | AS · PA/NP assist | $120.23 | $120.23 | $204.17 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $524.81 Median $524.81 Typical High $870.96 | Professional | TC · Technical part | $524.81 | $524.81 | $870.96 |
Where South Carolina sits
The same service costs 2.2 times more in Kansas than in Utah. 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· 27th of 51
$603
KS $1,000UT $457
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.