How much rates vary
Facilitymedian $331 · 10th to 90th $263 to $537Professionalmedian $309 · 10th to 90th $245 to $537
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 $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | None (both parts) | $263.03 | $263.03 | $338.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $489.78 Median $537.03 Typical High $537.03 | Facility | None | $489.78 | $537.03 | $537.03 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $309.03 Median $436.52 Typical High $537.03 | Professional | None (both parts) | $309.03 | $436.52 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Cigna Setting Professional Modifier None (both parts) Typical Low $239.88 Median $239.88 Typical High $331.13 | Professional | None (both parts) | $239.88 | $239.88 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $380.19 | Professional | None | $263.03 | $263.03 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $302.00 Typical High $660.69 | Facility | None | $169.82 | $302.00 | $660.69 |
Medcost Setting Professional Modifier None (both parts) Typical Low $295.12 Median $380.19 Typical High $707.95 | Professional | None (both parts) | $295.12 | $380.19 | $707.95 |
Molina Setting Professional Modifier None (both parts) Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None (both parts) | $354.81 | $354.81 | $354.81 |
United Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $724.44 | Facility | None | $354.81 | $363.08 | $724.44 |
United Setting Professional Modifier None (both parts) Typical Low $199.53 Median $263.03 Typical High $331.13 | Professional | None (both parts) | $199.53 | $263.03 | $331.13 |
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 $131.83 Median $131.83 Typical High $158.49 | Professional | 52 · Reduced service | $131.83 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $63.10 | Professional | 53 · Discontinued | $52.48 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $47.86 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $31.62 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $151.36 Median $158.49 Typical High $371.54 | Professional | 26 · Professional part | $151.36 | $158.49 | $371.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $575.44 Typical High $1,412.54 | Professional | 50 · Both sides | $446.68 | $575.44 | $1,412.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $147.91 Median $190.55 Typical High $467.74 | Professional | 51 · Multiple procedures | $147.91 | $190.55 | $467.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $75.86 Typical High $186.21 | Professional | 80 · Assistant surgeon | $60.26 | $75.86 | $186.21 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $41.69 Median $53.70 Typical High $131.83 | Professional | 81 · Minimal assistant surgeon | $41.69 | $53.70 | $131.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $41.69 Median $53.70 Typical High $131.83 | Professional | 82 · Assistant surgeon, no resident | $41.69 | $53.70 | $131.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $53.70 Typical High $131.83 | Professional | AS · PA/NP assist | $41.69 | $53.70 | $131.83 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $229.09 Median $239.88 Typical High $562.34 | Professional | TC · Technical part | $229.09 | $239.88 | $562.34 |
Where South Carolina sits
The same service costs 4.1 times more in Hawaii 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· 43rd of 51
$309
HI $1,000FL $245
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.