How much rates vary
Facilitymedian $550 · 10th to 90th $437 to $933Professionalmedian $537 · 10th to 90th $417 to $933
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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None (both parts) Typical Low $457.09 Median $457.09 Typical High $707.95 | Professional | None (both parts) | $457.09 | $457.09 | $707.95 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None (both parts) | $851.14 | $851.14 | $851.14 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $933.25 Typical High $933.25 | Facility | None | $851.14 | $933.25 | $933.25 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $537.03 Median $776.25 Typical High $933.25 | Professional | None (both parts) | $537.03 | $776.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None (both parts) | $398.11 | $398.11 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $478.63 | Professional | None | $398.11 | $398.11 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,148.15 | Facility | None | $257.04 | $537.03 | $1,148.15 |
Medcost Setting Professional Modifier None (both parts) Typical Low $524.81 Median $660.69 Typical High $1,230.27 | Professional | None (both parts) | $524.81 | $660.69 | $1,230.27 |
Molina Setting Professional Modifier None (both parts) Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None (both parts) | $630.96 | $630.96 | $630.96 |
United Setting Facility Modifier None Typical Low $331.13 Median $436.52 Typical High $1,096.48 | Facility | None | $331.13 | $436.52 | $1,096.48 |
United Setting Professional Modifier None (both parts) Typical Low $309.03 Median $446.68 Typical High $549.54 | Professional | None (both parts) | $309.03 | $446.68 | $549.54 |
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 $229.09 Median $229.09 Typical High $275.42 | Professional | 52 · Reduced service | $229.09 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | 53 · Discontinued | $91.20 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $54.95 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $54.95 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $263.03 Median $275.42 Typical High $660.69 | Professional | 26 · Professional part | $263.03 | $275.42 | $660.69 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,000.00 Typical High $2,454.71 | Professional | 50 · Both sides | $776.25 | $1,000.00 | $2,454.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $331.13 Typical High $812.83 | Professional | 51 · Multiple procedures | $257.04 | $331.13 | $812.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $131.83 Typical High $323.59 | Professional | 80 · Assistant surgeon | $104.71 | $131.83 | $323.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $72.44 Median $93.33 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $72.44 | $93.33 | $229.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $72.44 Median $93.33 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $72.44 | $93.33 | $229.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $93.33 Typical High $229.09 | Professional | AS · PA/NP assist | $72.44 | $93.33 | $229.09 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $398.11 Median $416.87 Typical High $977.24 | Professional | TC · Technical part | $398.11 | $416.87 | $977.24 |
Where South Carolina sits
The same service costs 2.4 times more in Iowa 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· 29th of 51
$537
IA $955DE $398
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.