How much rates vary
Facilitymedian $851 · 10th to 90th $759 to $1,549Professionalmedian $891 · 10th to 90th $676 to $1,549
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 $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier None (both parts) Typical Low $758.58 Median $758.58 Typical High $912.01 | Professional | None (both parts) | $758.58 | $758.58 | $912.01 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,412.54 | $1,548.82 | $1,548.82 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $891.25 Median $1,288.25 Typical High $1,548.82 | Professional | None (both parts) | $891.25 | $1,288.25 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Professional Modifier None (both parts) Typical Low $616.60 Median $616.60 Typical High $912.01 | Professional | None (both parts) | $616.60 | $616.60 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $891.25 | Professional | None | $676.08 | $676.08 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $812.83 Typical High $1,905.46 | Facility | None | $436.52 | $812.83 | $1,905.46 |
Medcost Setting Professional Modifier None (both parts) Typical Low $870.96 Median $1,096.48 Typical High $2,041.74 | Professional | None (both parts) | $870.96 | $1,096.48 | $2,041.74 |
Molina Setting Professional Modifier None (both parts) Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None (both parts) | $1,047.13 | $1,047.13 | $1,047.13 |
United Setting Facility Modifier None Typical Low $630.96 Median $776.25 Typical High $1,819.70 | Facility | None | $630.96 | $776.25 | $1,819.70 |
United Setting Professional Modifier None (both parts) Typical Low $512.86 Median $741.31 Typical High $912.01 | Professional | None (both parts) | $512.86 | $741.31 | $912.01 |
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 $380.19 Median $380.19 Typical High $457.09 | Professional | 52 · Reduced service | $380.19 | $380.19 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $181.97 | Professional | 53 · Discontinued | $151.36 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $91.20 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $91.20 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $436.52 Median $457.09 Typical High $1,096.48 | Professional | 26 · Professional part | $436.52 | $457.09 | $1,096.48 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,659.59 Typical High $4,073.80 | Professional | 50 · Both sides | $1,288.25 | $1,659.59 | $4,073.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $549.54 Typical High $1,348.96 | Professional | 51 · Multiple procedures | $426.58 | $549.54 | $1,348.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $218.78 Typical High $537.03 | Professional | 80 · Assistant surgeon | $173.78 | $218.78 | $537.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $120.23 Median $154.88 Typical High $380.19 | Professional | 81 · Minimal assistant surgeon | $120.23 | $154.88 | $380.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $154.88 Typical High $380.19 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $154.88 | $380.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $154.88 Typical High $380.19 | Professional | AS · PA/NP assist | $120.23 | $154.88 | $380.19 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $660.69 Median $691.83 Typical High $1,621.81 | Professional | TC · Technical part | $660.69 | $691.83 | $1,621.81 |
Where South Carolina sits
The same service costs 3.0 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· 21st of 51
$891
HI $1,820DE $617
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.