How much rates vary
Facilitymedian $339 · 10th to 90th $269 to $562Professionalmedian $316 · 10th to 90th $245 to $562
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 $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier None (both parts) Typical Low $269.15 Median $269.15 Typical High $331.13 | Professional | None (both parts) | $269.15 | $269.15 | $331.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $562.34 Typical High $562.34 | Facility | None | $501.19 | $562.34 | $562.34 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $316.23 Median $457.09 Typical High $562.34 | Professional | None (both parts) | $316.23 | $457.09 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None (both parts) Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | None (both parts) | $245.47 | $245.47 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $323.59 | Professional | None | $316.23 | $316.23 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $173.78 Median $302.00 Typical High $676.08 | Facility | None | $173.78 | $302.00 | $676.08 |
Medcost Setting Professional Modifier None (both parts) Typical Low $309.03 Median $389.05 Typical High $724.44 | Professional | None (both parts) | $309.03 | $389.05 | $724.44 |
Molina Setting Professional Modifier None (both parts) Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None (both parts) | $371.54 | $371.54 | $371.54 |
United Setting Facility Modifier None Typical Low $354.81 Median $407.38 Typical High $724.44 | Facility | None | $354.81 | $407.38 | $724.44 |
United Setting Professional Modifier None (both parts) Typical Low $204.17 Median $269.15 Typical High $346.74 | Professional | None (both parts) | $204.17 | $269.15 | $346.74 |
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 $134.90 Median $134.90 Typical High $165.96 | Professional | 52 · Reduced service | $134.90 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $66.07 | Professional | 53 · Discontinued | $53.70 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $33.11 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $33.11 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $158.49 Median $165.96 Typical High $389.05 | Professional | 26 · Professional part | $158.49 | $165.96 | $389.05 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $588.84 Typical High $1,445.44 | Professional | 50 · Both sides | $457.09 | $588.84 | $1,445.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $154.88 Median $194.98 Typical High $489.78 | Professional | 51 · Multiple procedures | $154.88 | $194.98 | $489.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $79.43 Typical High $194.98 | Professional | 80 · Assistant surgeon | $61.66 | $79.43 | $194.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $42.66 Median $54.95 Typical High $134.90 | Professional | 81 · Minimal assistant surgeon | $42.66 | $54.95 | $134.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $42.66 Median $54.95 Typical High $134.90 | Professional | 82 · Assistant surgeon, no resident | $42.66 | $54.95 | $134.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $54.95 Typical High $134.90 | Professional | AS · PA/NP assist | $42.66 | $54.95 | $134.90 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $234.42 Median $245.47 Typical High $575.44 | Professional | TC · Technical part | $234.42 | $245.47 | $575.44 |
Where South Carolina sits
The same service costs 4.2 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· 41st of 51
$316
HI $1,023DE $245
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.