How much rates vary
Facilitymedian $295 · 10th to 90th $234 to $490Professionalmedian $275 · 10th to 90th $219 to $490
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 $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None (both parts) Typical Low $234.42 Median $234.42 Typical High $295.12 | Professional | None (both parts) | $234.42 | $234.42 | $295.12 |
BCBS South Carolina Setting Facility Modifier None Typical Low $436.52 Median $489.78 Typical High $489.78 | Facility | None | $436.52 | $489.78 | $489.78 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $275.42 Median $398.11 Typical High $489.78 | Professional | None (both parts) | $275.42 | $398.11 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Professional Modifier None (both parts) Typical Low $218.78 Median $218.78 Typical High $295.12 | Professional | None (both parts) | $218.78 | $218.78 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $288.40 | Professional | None | $251.19 | $251.19 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $269.15 Typical High $588.84 | Facility | None | $154.88 | $269.15 | $588.84 |
Medcost Setting Professional Modifier None (both parts) Typical Low $269.15 Median $338.84 Typical High $630.96 | Professional | None (both parts) | $269.15 | $338.84 | $630.96 |
Molina Setting Professional Modifier None (both parts) Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None (both parts) | $323.59 | $323.59 | $323.59 |
United Setting Facility Modifier None Typical Low $316.23 Median $346.74 Typical High $645.65 | Facility | None | $316.23 | $346.74 | $645.65 |
United Setting Professional Modifier None (both parts) Typical Low $181.97 Median $239.88 Typical High $302.00 | Professional | None (both parts) | $181.97 | $239.88 | $302.00 |
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 $117.49 Median $117.49 Typical High $147.91 | Professional | 52 · Reduced service | $117.49 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $58.88 | Professional | 53 · Discontinued | $46.77 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $43.65 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $29.51 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $29.51 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $138.04 Median $144.54 Typical High $338.84 | Professional | 26 · Professional part | $138.04 | $144.54 | $338.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $512.86 Typical High $1,258.93 | Professional | 50 · Both sides | $398.11 | $512.86 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $169.82 Typical High $416.87 | Professional | 51 · Multiple procedures | $134.90 | $169.82 | $416.87 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $69.18 Typical High $169.82 | Professional | 80 · Assistant surgeon | $53.70 | $69.18 | $169.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $37.15 Median $47.86 Typical High $117.49 | Professional | 81 · Minimal assistant surgeon | $37.15 | $47.86 | $117.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $37.15 Median $47.86 Typical High $117.49 | Professional | 82 · Assistant surgeon, no resident | $37.15 | $47.86 | $117.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $47.86 Typical High $117.49 | Professional | AS · PA/NP assist | $37.15 | $47.86 | $117.49 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $204.17 Median $213.80 Typical High $501.19 | Professional | TC · Technical part | $204.17 | $213.80 | $501.19 |
Where South Carolina sits
The same service costs 4.2 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· 40th of 51
$275
HI $912DE $219
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.