How much rates vary
Facilitymedian $87 · 10th to 90th $76 to $158Professionalmedian $89 · 10th to 90th $68 to $158
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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None (both parts) Typical Low $75.86 Median $75.86 Typical High $117.49 | Professional | None (both parts) | $75.86 | $75.86 | $117.49 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None (both parts) | $158.49 | $158.49 | $158.49 |
BCBS South Carolina Setting Facility Modifier None Typical Low $141.25 Median $158.49 Typical High $158.49 | Facility | None | $141.25 | $158.49 | $158.49 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $89.13 Median $128.82 Typical High $158.49 | Professional | None (both parts) | $89.13 | $128.82 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $87.10 Typical High $87.10 | Facility | None | $81.28 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None (both parts) Typical Low $63.10 Median $63.10 Typical High $93.33 | Professional | None (both parts) | $63.10 | $63.10 | $93.33 |
Medcost Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | None | $67.61 | $67.61 | $81.28 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $81.28 Typical High $190.55 | Facility | None | $43.65 | $81.28 | $190.55 |
Medcost Setting Professional Modifier None (both parts) Typical Low $87.10 Median $112.20 Typical High $204.17 | Professional | None (both parts) | $87.10 | $112.20 | $204.17 |
Molina Setting Professional Modifier None (both parts) Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None (both parts) | $104.71 | $104.71 | $104.71 |
United Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $186.21 | Facility | None | $91.20 | $120.23 | $186.21 |
United Setting Professional Modifier None (both parts) Typical Low $52.48 Median $75.86 Typical High $93.33 | Professional | None (both parts) | $52.48 | $75.86 | $93.33 |
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 $38.02 Median $38.02 Typical High $46.77 | Professional | 52 · Reduced service | $38.02 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $18.62 | Professional | 53 · Discontinued | $15.49 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $13.80 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $9.33 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $44.67 Median $46.77 Typical High $109.65 | Professional | 26 · Professional part | $44.67 | $46.77 | $109.65 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $165.96 Typical High $407.38 | Professional | 50 · Both sides | $131.83 | $165.96 | $407.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $43.65 Median $57.54 Typical High $138.04 | Professional | 51 · Multiple procedures | $43.65 | $57.54 | $138.04 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $17.38 Median $22.39 Typical High $54.95 | Professional | 80 · Assistant surgeon | $17.38 | $22.39 | $54.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.30 Median $15.49 Typical High $38.02 | Professional | 81 · Minimal assistant surgeon | $12.30 | $15.49 | $38.02 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.30 Median $15.49 Typical High $38.02 | Professional | 82 · Assistant surgeon, no resident | $12.30 | $15.49 | $38.02 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.30 Median $15.49 Typical High $38.02 | Professional | AS · PA/NP assist | $12.30 | $15.49 | $38.02 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $66.07 Median $69.18 Typical High $165.96 | Professional | TC · Technical part | $66.07 | $69.18 | $165.96 |
Where South Carolina sits
The same service costs 5.0 times more in Hawaii than in Delaware. 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· 26th of 51
$89.13
HI $316DE $63.10
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.