How much rates vary
Facilitymedian $347 · 10th to 90th $219 to $447Professionalmedian $257 · 10th to 90th $219 to $447
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 $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier None (both parts) Typical Low $218.78 Median $218.78 Typical High $338.84 | Professional | None (both parts) | $218.78 | $218.78 | $338.84 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None (both parts) | $346.74 | $346.74 | $346.74 |
BCBS South Carolina Setting Facility Modifier None Typical Low $407.38 Median $446.68 Typical High $446.68 | Facility | None | $407.38 | $446.68 | $446.68 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $257.04 Median $371.54 Typical High $446.68 | Professional | None (both parts) | $257.04 | $371.54 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None (both parts) Typical Low $251.19 Median $251.19 Typical High $346.74 | Professional | None (both parts) | $251.19 | $251.19 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $295.12 | Professional | None | $234.42 | $234.42 | $295.12 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $263.03 Typical High $549.54 | Facility | None | $141.25 | $263.03 | $549.54 |
Medcost Setting Professional Modifier None (both parts) Typical Low $251.19 Median $316.23 Typical High $588.84 | Professional | None (both parts) | $251.19 | $316.23 | $588.84 |
Molina Setting Professional Modifier None (both parts) Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None (both parts) | $302.00 | $302.00 | $302.00 |
United Setting Facility Modifier None Typical Low $295.12 Median $389.05 Typical High $602.56 | Facility | None | $295.12 | $389.05 | $602.56 |
United Setting Professional Modifier None (both parts) Typical Low $169.82 Median $218.78 Typical High $275.42 | Professional | None (both parts) | $169.82 | $218.78 | $275.42 |
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 $109.65 Median $109.65 Typical High $131.83 | Professional | 52 · Reduced service | $109.65 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $52.48 | Professional | 53 · Discontinued | $43.65 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $39.81 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $26.30 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $26.30 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $125.89 Median $131.83 Typical High $316.23 | Professional | 26 · Professional part | $125.89 | $131.83 | $316.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $478.63 Typical High $1,174.90 | Professional | 50 · Both sides | $371.54 | $478.63 | $1,174.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $158.49 Typical High $389.05 | Professional | 51 · Multiple procedures | $125.89 | $158.49 | $389.05 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $63.10 Typical High $154.88 | Professional | 80 · Assistant surgeon | $50.12 | $63.10 | $154.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $34.67 Median $44.67 Typical High $109.65 | Professional | 81 · Minimal assistant surgeon | $34.67 | $44.67 | $109.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $34.67 Median $44.67 Typical High $109.65 | Professional | 82 · Assistant surgeon, no resident | $34.67 | $44.67 | $109.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $44.67 Typical High $109.65 | Professional | AS · PA/NP assist | $34.67 | $44.67 | $109.65 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $190.55 Median $199.53 Typical High $467.74 | Professional | TC · Technical part | $190.55 | $199.53 | $467.74 |
Where South Carolina sits
The same service costs 3.8 times more in Hawaii than in Florida. 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· 43rd of 51
$257
HI $912FL $240
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.