How much rates vary
Facilitymedian $245 · 10th to 90th $178 to $363Professionalmedian $204 · 10th to 90th $174 to $363
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 $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $177.83 Median $177.83 Typical High $213.80 | Professional | None (both parts) | $177.83 | $177.83 | $213.80 |
BCBS South Carolina Setting Facility Modifier None Typical Low $323.59 Median $363.08 Typical High $363.08 | Facility | None | $323.59 | $363.08 | $363.08 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $204.17 Median $295.12 Typical High $363.08 | Professional | None (both parts) | $204.17 | $295.12 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None (both parts) Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None (both parts) | $177.83 | $177.83 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $218.78 | Professional | None | $208.93 | $208.93 | $218.78 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $199.53 Typical High $436.52 | Facility | None | $114.82 | $199.53 | $436.52 |
Medcost Setting Professional Modifier None (both parts) Typical Low $199.53 Median $257.04 Typical High $478.63 | Professional | None (both parts) | $199.53 | $257.04 | $478.63 |
Molina Setting Professional Modifier None (both parts) Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None (both parts) | $239.88 | $239.88 | $239.88 |
United Setting Facility Modifier None Typical Low $199.53 Median $234.42 Typical High $478.63 | Facility | None | $199.53 | $234.42 | $478.63 |
United Setting Professional Modifier None (both parts) Typical Low $134.90 Median $177.83 Typical High $223.87 | Professional | None (both parts) | $134.90 | $177.83 | $223.87 |
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 $87.10 Median $87.10 Typical High $107.15 | Professional | 52 · Reduced service | $87.10 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $42.66 | Professional | 53 · Discontinued | $35.48 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $31.62 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $21.38 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $21.38 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $102.33 Median $107.15 Typical High $251.19 | Professional | 26 · Professional part | $102.33 | $107.15 | $251.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $380.19 Typical High $933.25 | Professional | 50 · Both sides | $302.00 | $380.19 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $100.00 Median $128.82 Typical High $316.23 | Professional | 51 · Multiple procedures | $100.00 | $128.82 | $316.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $51.29 Typical High $125.89 | Professional | 80 · Assistant surgeon | $39.81 | $51.29 | $125.89 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.18 Median $35.48 Typical High $87.10 | Professional | 81 · Minimal assistant surgeon | $28.18 | $35.48 | $87.10 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $28.18 Median $35.48 Typical High $87.10 | Professional | 82 · Assistant surgeon, no resident | $28.18 | $35.48 | $87.10 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $28.18 Median $35.48 Typical High $87.10 | Professional | AS · PA/NP assist | $28.18 | $35.48 | $87.10 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $151.36 Median $158.49 Typical High $380.19 | Professional | TC · Technical part | $151.36 | $158.49 | $380.19 |
Where South Carolina sits
The same service costs 3.2 times more in Hawaii than in Alabama. 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· 37th of 51
$204
HI $562AL $178
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.