How much rates vary
Facilitymedian $141 · 10th to 90th $112 to $309Professionalmedian $132 · 10th to 90th $105 to $229
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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None (both parts) Typical Low $112.20 Median $112.20 Typical High $134.90 | Professional | None (both parts) | $112.20 | $112.20 | $134.90 |
BCBS South Carolina Setting Facility Modifier None Typical Low $208.93 Median $229.09 Typical High $229.09 | Facility | None | $208.93 | $229.09 | $229.09 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $131.83 Median $186.21 Typical High $229.09 | Professional | None (both parts) | $131.83 | $186.21 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None (both parts) Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None (both parts) | $102.33 | $102.33 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | None | $117.49 | $117.49 | $134.90 |
Medcost Setting Facility Modifier None Typical Low $72.44 Median $125.89 Typical High $275.42 | Facility | None | $72.44 | $125.89 | $275.42 |
Medcost Setting Professional Modifier None (both parts) Typical Low $125.89 Median $162.18 Typical High $302.00 | Professional | None (both parts) | $125.89 | $162.18 | $302.00 |
Molina Setting Professional Modifier None (both parts) Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None (both parts) | $151.36 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $151.36 Median $309.03 Typical High $389.05 | Facility | None | $151.36 | $309.03 | $389.05 |
United Setting Professional Modifier None (both parts) Typical Low $85.11 Median $112.20 Typical High $141.25 | Professional | None (both parts) | $85.11 | $112.20 | $141.25 |
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 $56.23 Median $56.23 Typical High $67.61 | Professional | 52 · Reduced service | $56.23 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $26.92 | Professional | 53 · Discontinued | $22.39 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $20.42 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $13.49 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $13.49 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $64.57 Median $67.61 Typical High $158.49 | Professional | 26 · Professional part | $64.57 | $67.61 | $158.49 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $245.47 Typical High $602.56 | Professional | 50 · Both sides | $190.55 | $245.47 | $602.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $81.28 Typical High $199.53 | Professional | 51 · Multiple procedures | $63.10 | $81.28 | $199.53 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $32.36 Typical High $79.43 | Professional | 80 · Assistant surgeon | $25.12 | $32.36 | $79.43 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.78 Median $22.91 Typical High $56.23 | Professional | 81 · Minimal assistant surgeon | $17.78 | $22.91 | $56.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.78 Median $22.91 Typical High $56.23 | Professional | 82 · Assistant surgeon, no resident | $17.78 | $22.91 | $56.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.78 Median $22.91 Typical High $56.23 | Professional | AS · PA/NP assist | $17.78 | $22.91 | $56.23 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $97.72 Median $102.33 Typical High $239.88 | Professional | TC · Technical part | $97.72 | $102.33 | $239.88 |
Where South Carolina sits
The same service costs 8.1 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· 36th of 51
$132
HI $832DE $102
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.