How much rates vary
Facilitymedian $525 · 10th to 90th $309 to $851Professionalmedian $363 · 10th to 90th $309 to $631
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 $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $309.03 Median $309.03 Typical High $398.11 | Professional | None (both parts) | $309.03 | $309.03 | $398.11 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None (both parts) | $512.86 | $512.86 | $512.86 |
BCBS South Carolina Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $1,230.27 | Facility | None | $630.96 | $630.96 | $1,230.27 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $363.08 Median $524.81 Typical High $630.96 | Professional | None (both parts) | $363.08 | $524.81 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None (both parts) Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | None (both parts) | $380.19 | $380.19 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $398.11 | Professional | None | $316.23 | $316.23 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $354.81 Typical High $776.25 | Facility | None | $199.53 | $354.81 | $776.25 |
Medcost Setting Professional Modifier None (both parts) Typical Low $354.81 Median $446.68 Typical High $831.76 | Professional | None (both parts) | $354.81 | $446.68 | $831.76 |
Molina Setting Professional Modifier None (both parts) Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None (both parts) | $426.58 | $426.58 | $426.58 |
United Setting Facility Modifier None Typical Low $389.05 Median $416.87 Typical High $851.14 | Facility | None | $389.05 | $416.87 | $851.14 |
United Setting Professional Modifier None (both parts) Typical Low $239.88 Median $309.03 Typical High $398.11 | Professional | None (both parts) | $239.88 | $309.03 | $398.11 |
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 $154.88 Median $154.88 Typical High $190.55 | Professional | 52 · Reduced service | $154.88 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $77.62 | Professional | 53 · Discontinued | $61.66 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $57.54 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $38.90 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $177.83 Median $186.21 Typical High $446.68 | Professional | 26 · Professional part | $177.83 | $186.21 | $446.68 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $691.83 Typical High $1,659.59 | Professional | 50 · Both sides | $524.81 | $691.83 | $1,659.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $173.78 Median $229.09 Typical High $549.54 | Professional | 51 · Multiple procedures | $173.78 | $229.09 | $549.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $93.33 Typical High $218.78 | Professional | 80 · Assistant surgeon | $70.79 | $93.33 | $218.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $48.98 Median $64.57 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $48.98 | $64.57 | $154.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $48.98 Median $64.57 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $48.98 | $64.57 | $154.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $64.57 Typical High $154.88 | Professional | AS · PA/NP assist | $48.98 | $64.57 | $154.88 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $269.15 Median $281.84 Typical High $660.69 | Professional | TC · Technical part | $269.15 | $281.84 | $660.69 |
Where South Carolina sits
The same service costs 2.8 times more in Hawaii than in Maryland. 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· 47th of 51
$372
HI $977MD $355
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.