How much rates vary
Facilitymedian $170 · 10th to 90th $135 to $282Professionalmedian $158 · 10th to 90th $126 to $282
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 $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None (both parts) Typical Low $134.90 Median $134.90 Typical High $169.82 | Professional | None (both parts) | $134.90 | $134.90 | $169.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $251.19 Median $281.84 Typical High $281.84 | Facility | None | $251.19 | $281.84 | $281.84 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $158.49 Median $229.09 Typical High $281.84 | Professional | None (both parts) | $158.49 | $229.09 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None (both parts) Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None (both parts) | $125.89 | $125.89 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $154.88 Typical High $338.84 | Facility | None | $89.13 | $154.88 | $338.84 |
Medcost Setting Professional Modifier None (both parts) Typical Low $154.88 Median $194.98 Typical High $363.08 | Professional | None (both parts) | $154.88 | $194.98 | $363.08 |
Molina Setting Professional Modifier None (both parts) Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None (both parts) | $186.21 | $186.21 | $186.21 |
United Setting Facility Modifier None Typical Low $181.97 Median $229.09 Typical High $371.54 | Facility | None | $181.97 | $229.09 | $371.54 |
United Setting Professional Modifier None (both parts) Typical Low $104.71 Median $138.04 Typical High $169.82 | Professional | None (both parts) | $104.71 | $138.04 | $169.82 |
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 $67.61 Median $67.61 Typical High $85.11 | Professional | 52 · Reduced service | $67.61 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $33.88 | Professional | 53 · Discontinued | $26.92 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $25.12 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $16.98 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $77.62 Median $83.18 Typical High $194.98 | Professional | 26 · Professional part | $77.62 | $83.18 | $194.98 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $295.12 Typical High $724.44 | Professional | 50 · Both sides | $229.09 | $295.12 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $97.72 Typical High $239.88 | Professional | 51 · Multiple procedures | $77.62 | $97.72 | $239.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.90 Median $38.90 Typical High $97.72 | Professional | 80 · Assistant surgeon | $30.90 | $38.90 | $97.72 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.38 Median $27.54 Typical High $67.61 | Professional | 81 · Minimal assistant surgeon | $21.38 | $27.54 | $67.61 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.38 Median $27.54 Typical High $67.61 | Professional | 82 · Assistant surgeon, no resident | $21.38 | $27.54 | $67.61 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $21.38 Median $27.54 Typical High $67.61 | Professional | AS · PA/NP assist | $21.38 | $27.54 | $67.61 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $117.49 Median $123.03 Typical High $288.40 | Professional | TC · Technical part | $117.49 | $123.03 | $288.40 |
Where South Carolina sits
The same service costs 4.7 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
$158
HI $589DE $126
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.