How much rates vary
Facilitymedian $407 · 10th to 90th $347 to $724Professionalmedian $407 · 10th to 90th $316 to $724
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 $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None (both parts) Typical Low $346.74 Median $346.74 Typical High $426.58 | Professional | None (both parts) | $346.74 | $346.74 | $426.58 |
BCBS South Carolina Setting Facility Modifier None Typical Low $645.65 Median $724.44 Typical High $724.44 | Facility | None | $645.65 | $724.44 | $724.44 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $407.38 Median $588.84 Typical High $724.44 | Professional | None (both parts) | $407.38 | $588.84 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None (both parts) Typical Low $295.12 Median $295.12 Typical High $426.58 | Professional | None (both parts) | $295.12 | $295.12 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $389.05 | Professional | None | $371.54 | $371.54 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $380.19 Typical High $870.96 | Facility | None | $208.93 | $380.19 | $870.96 |
Medcost Setting Professional Modifier None (both parts) Typical Low $398.11 Median $501.19 Typical High $933.25 | Professional | None (both parts) | $398.11 | $501.19 | $933.25 |
Molina Setting Professional Modifier None (both parts) Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None (both parts) | $478.63 | $478.63 | $478.63 |
United Setting Facility Modifier None Typical Low $436.52 Median $575.44 Typical High $891.25 | Facility | None | $436.52 | $575.44 | $891.25 |
United Setting Professional Modifier None (both parts) Typical Low $251.19 Median $346.74 Typical High $426.58 | Professional | None (both parts) | $251.19 | $346.74 | $426.58 |
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 $173.78 Median $173.78 Typical High $208.93 | Professional | 52 · Reduced service | $173.78 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $85.11 | Professional | 53 · Discontinued | $69.18 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $63.10 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $42.66 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $42.66 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $199.53 Median $213.80 Typical High $501.19 | Professional | 26 · Professional part | $199.53 | $213.80 | $501.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $758.58 Typical High $1,862.09 | Professional | 50 · Both sides | $588.84 | $758.58 | $1,862.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $199.53 Median $251.19 Typical High $616.60 | Professional | 51 · Multiple procedures | $199.53 | $251.19 | $616.60 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $100.00 Typical High $251.19 | Professional | 80 · Assistant surgeon | $79.43 | $100.00 | $251.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $54.95 Median $70.79 Typical High $173.78 | Professional | 81 · Minimal assistant surgeon | $54.95 | $70.79 | $173.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $54.95 Median $70.79 Typical High $173.78 | Professional | 82 · Assistant surgeon, no resident | $54.95 | $70.79 | $173.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $70.79 Typical High $173.78 | Professional | AS · PA/NP assist | $54.95 | $70.79 | $173.78 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $302.00 Median $316.23 Typical High $741.31 | Professional | TC · Technical part | $302.00 | $316.23 | $741.31 |
Where South Carolina sits
The same service costs 4.3 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· 28th of 51
$407
HI $1,259DE $295
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.