How much rates vary
Facilitymedian $1,175 · 10th to 90th $955 to $1,950Professionalmedian $1,122 · 10th to 90th $871 to $1,950
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 $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier None (both parts) Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Professional | None (both parts) | $954.99 | $954.99 | $1,148.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,778.28 | $1,949.84 | $1,949.84 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,584.89 Typical High $1,949.84 | Professional | None (both parts) | $1,122.02 | $1,584.89 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Professional Modifier None (both parts) Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | None (both parts) | $851.14 | $851.14 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,202.26 | Professional | None | $933.25 | $933.25 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,047.13 Typical High $2,398.83 | Facility | None | $602.56 | $1,047.13 | $2,398.83 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,071.52 Median $1,380.38 Typical High $2,570.40 | Professional | None (both parts) | $1,071.52 | $1,380.38 | $2,570.40 |
Molina Setting Professional Modifier None (both parts) Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None (both parts) | $1,288.25 | $1,288.25 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $2,570.40 | Facility | None | $1,122.02 | $1,258.93 | $2,570.40 |
United Setting Professional Modifier None (both parts) Typical Low $724.44 Median $954.99 Typical High $1,202.26 | Professional | None (both parts) | $724.44 | $954.99 | $1,202.26 |
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 $478.63 Median $478.63 Typical High $575.44 | Professional | 52 · Reduced service | $478.63 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $229.09 | Professional | 53 · Discontinued | $190.55 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $173.78 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $114.82 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $114.82 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $549.54 Median $575.44 Typical High $1,348.96 | Professional | 26 · Professional part | $549.54 | $575.44 | $1,348.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,089.30 Typical High $5,128.61 | Professional | 50 · Both sides | $1,621.81 | $2,089.30 | $5,128.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $691.83 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $537.03 | $691.83 | $1,698.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $275.42 Typical High $676.08 | Professional | 80 · Assistant surgeon | $218.78 | $275.42 | $676.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $194.98 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $151.36 | $194.98 | $478.63 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $194.98 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $194.98 | $478.63 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $194.98 Typical High $478.63 | Professional | AS · PA/NP assist | $151.36 | $194.98 | $478.63 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $831.76 Median $870.96 Typical High $2,041.74 | Professional | TC · Technical part | $831.76 | $870.96 | $2,041.74 |
Where South Carolina sits
The same service costs 3.3 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· 34th of 51
$1,122
HI $2,818DE $851
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.