How much rates vary
Facilitymedian $245 · 10th to 90th $195 to $398Professionalmedian $229 · 10th to 90th $178 to $398
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 $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None (both parts) Typical Low $194.98 Median $194.98 Typical High $245.47 | Professional | None (both parts) | $194.98 | $194.98 | $245.47 |
BCBS South Carolina Setting Facility Modifier None Typical Low $363.08 Median $398.11 Typical High $398.11 | Facility | None | $363.08 | $398.11 | $398.11 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $229.09 Median $331.13 Typical High $398.11 | Professional | None (both parts) | $229.09 | $331.13 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None (both parts) Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None (both parts) | $177.83 | $177.83 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | None | $204.17 | $204.17 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $223.87 Typical High $489.78 | Facility | None | $125.89 | $223.87 | $489.78 |
Medcost Setting Professional Modifier None (both parts) Typical Low $218.78 Median $281.84 Typical High $524.81 | Professional | None (both parts) | $218.78 | $281.84 | $524.81 |
United Setting Facility Modifier None Typical Low $147.91 Median $204.17 Typical High $537.03 | Facility | None | $147.91 | $204.17 | $537.03 |
United Setting Professional Modifier None (both parts) Typical Low $151.36 Median $194.98 Typical High $245.47 | Professional | None (both parts) | $151.36 | $194.98 | $245.47 |
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 $97.72 Median $97.72 Typical High $120.23 | Professional | 52 · Reduced service | $97.72 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $48.98 | Professional | 53 · Discontinued | $38.90 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $36.31 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $24.55 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $24.55 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $112.20 Median $117.49 Typical High $281.84 | Professional | 26 · Professional part | $112.20 | $117.49 | $281.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $426.58 Typical High $1,047.13 | Professional | 50 · Both sides | $331.13 | $426.58 | $1,047.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $109.65 Median $141.25 Typical High $346.74 | Professional | 51 · Multiple procedures | $109.65 | $141.25 | $346.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $44.67 Median $56.23 Typical High $138.04 | Professional | 80 · Assistant surgeon | $44.67 | $56.23 | $138.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $30.90 Median $39.81 Typical High $97.72 | Professional | 81 · Minimal assistant surgeon | $30.90 | $39.81 | $97.72 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.90 Median $39.81 Typical High $97.72 | Professional | 82 · Assistant surgeon, no resident | $30.90 | $39.81 | $97.72 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $30.90 Median $39.81 Typical High $97.72 | Professional | AS · PA/NP assist | $30.90 | $39.81 | $97.72 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $169.82 Median $177.83 Typical High $416.87 | Professional | TC · Technical part | $169.82 | $177.83 | $416.87 |
Where South Carolina sits
The same service costs 2.9 times more in Montana 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· 41st of 51
$229
MT $513DE $178
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.