How much rates vary
Facilitymedian $158 · 10th to 90th $129 to $263Professionalmedian $151 · 10th to 90th $117 to $263
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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $128.82 Median $128.82 Typical High $162.18 | Professional | None (both parts) | $128.82 | $128.82 | $162.18 |
BCBS South Carolina Setting Facility Modifier None Typical Low $239.88 Median $263.03 Typical High $263.03 | Facility | None | $239.88 | $263.03 | $263.03 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $151.36 Median $218.78 Typical High $263.03 | Professional | None (both parts) | $151.36 | $218.78 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None (both parts) Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None (both parts) | $117.49 | $117.49 | $158.49 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $181.97 | Professional | None | $128.82 | $128.82 | $181.97 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $154.88 Typical High $323.59 | Facility | None | $83.18 | $154.88 | $323.59 |
Medcost Setting Professional Modifier None (both parts) Typical Low $144.54 Median $186.21 Typical High $346.74 | Professional | None (both parts) | $144.54 | $186.21 | $346.74 |
Molina Setting Professional Modifier None (both parts) Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None (both parts) | $177.83 | $177.83 | $177.83 |
United Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $346.74 | Facility | None | $141.25 | $169.82 | $346.74 |
United Setting Professional Modifier None (both parts) Typical Low $97.72 Median $128.82 Typical High $162.18 | Professional | None (both parts) | $97.72 | $128.82 | $162.18 |
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 $64.57 Median $64.57 Typical High $79.43 | Professional | 52 · Reduced service | $64.57 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $32.36 | Professional | 53 · Discontinued | $25.70 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $23.99 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $16.22 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $74.13 Median $77.62 Typical High $186.21 | Professional | 26 · Professional part | $74.13 | $77.62 | $186.21 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $281.84 Typical High $691.83 | Professional | 50 · Both sides | $218.78 | $281.84 | $691.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $93.33 Typical High $229.09 | Professional | 51 · Multiple procedures | $72.44 | $93.33 | $229.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $29.51 Median $37.15 Typical High $91.20 | Professional | 80 · Assistant surgeon | $29.51 | $37.15 | $91.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $20.42 Median $26.30 Typical High $64.57 | Professional | 81 · Minimal assistant surgeon | $20.42 | $26.30 | $64.57 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $20.42 Median $26.30 Typical High $64.57 | Professional | 82 · Assistant surgeon, no resident | $20.42 | $26.30 | $64.57 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $20.42 Median $26.30 Typical High $64.57 | Professional | AS · PA/NP assist | $20.42 | $26.30 | $64.57 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $112.20 Median $117.49 Typical High $275.42 | Professional | TC · Technical part | $112.20 | $117.49 | $275.42 |
Where South Carolina sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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· 42nd of 51
$151
HI $468KS $107
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.