How much rates vary
Facilitymedian $178 · 10th to 90th $132 to $269Professionalmedian $162 · 10th to 90th $129 to $269
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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $131.83 Median $131.83 Typical High $186.21 | Professional | None (both parts) | $131.83 | $131.83 | $186.21 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None (both parts) | $204.17 | $204.17 | $204.17 |
BCBS South Carolina Setting Facility Modifier None Typical Low $102.33 Median $269.15 Typical High $269.15 | Facility | None | $102.33 | $269.15 | $269.15 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $154.88 Median $199.53 Typical High $269.15 | Professional | None (both parts) | $154.88 | $199.53 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $190.55 | Facility | None | $177.83 | $177.83 | $190.55 |
Cigna Setting Professional Modifier None (both parts) Typical Low $128.82 Median $128.82 Typical High $190.55 | Professional | None (both parts) | $128.82 | $128.82 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $177.83 | Professional | None | $158.49 | $177.83 | $177.83 |
Medcost Setting Facility Modifier None Typical Low $85.11 Median $158.49 Typical High $331.13 | Facility | None | $85.11 | $158.49 | $331.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $151.36 Median $190.55 Typical High $354.81 | Professional | None (both parts) | $151.36 | $190.55 | $354.81 |
Molina Setting Professional Modifier None (both parts) Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None (both parts) | $181.97 | $181.97 | $181.97 |
United Setting Facility Modifier None Typical Low $177.83 Median $186.21 Typical High $363.08 | Facility | None | $177.83 | $186.21 | $363.08 |
United Setting Professional Modifier None (both parts) Typical Low $102.33 Median $131.83 Typical High $165.96 | Professional | None (both parts) | $102.33 | $131.83 | $165.96 |
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 $66.07 Median $66.07 Typical High $81.28 | Professional | 52 · Reduced service | $66.07 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $33.11 | Professional | 53 · Discontinued | $26.30 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $24.55 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $16.60 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $16.60 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $75.86 Median $79.43 Typical High $190.55 | Professional | 26 · Professional part | $75.86 | $79.43 | $190.55 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $223.87 Median $288.40 Typical High $707.95 | Professional | 50 · Both sides | $223.87 | $288.40 | $707.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $100.00 Typical High $234.42 | Professional | 51 · Multiple procedures | $75.86 | $100.00 | $234.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.20 Median $38.02 Typical High $93.33 | Professional | 80 · Assistant surgeon | $30.20 | $38.02 | $93.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $20.89 Median $26.92 Typical High $66.07 | Professional | 81 · Minimal assistant surgeon | $20.89 | $26.92 | $66.07 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $20.89 Median $26.92 Typical High $66.07 | Professional | 82 · Assistant surgeon, no resident | $20.89 | $26.92 | $66.07 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $20.89 Median $26.92 Typical High $66.07 | Professional | AS · PA/NP assist | $20.89 | $26.92 | $66.07 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $114.82 Median $120.23 Typical High $281.84 | Professional | TC · Technical part | $114.82 | $120.23 | $281.84 |
Where South Carolina sits
The same service costs 3.5 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· 31st of 51
$166
HI $457DE $129
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.