How much rates vary
Facilitymedian $209 · 10th to 90th $186 to $389Professionalmedian $200 · 10th to 90th $170 to $389
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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None (both parts) Typical Low $186.21 Median $186.21 Typical High $331.13 | Professional | None (both parts) | $186.21 | $186.21 | $331.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $346.74 Median $389.05 Typical High $389.05 | Facility | None | $346.74 | $389.05 | $389.05 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $199.53 Median $288.40 Typical High $389.05 | Professional | None (both parts) | $199.53 | $288.40 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Professional Modifier None (both parts) Typical Low $154.88 Median $154.88 Typical High $229.09 | Professional | None (both parts) | $154.88 | $154.88 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $213.80 Typical High $467.74 | Facility | None | $109.65 | $213.80 | $467.74 |
Medcost Setting Professional Modifier None (both parts) Typical Low $218.78 Median $288.40 Typical High $512.86 | Professional | None (both parts) | $218.78 | $288.40 | $512.86 |
United Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
United Setting Professional Modifier None (both parts) Typical Low $128.82 Median $186.21 Typical High $229.09 | Professional | None (both parts) | $128.82 | $186.21 | $229.09 |
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 $93.33 Median $93.33 Typical High $114.82 | Professional | 52 · Reduced service | $93.33 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $45.71 | Professional | 53 · Discontinued | $38.02 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $33.88 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $22.91 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $112.20 Median $114.82 Typical High $269.15 | Professional | 26 · Professional part | $112.20 | $114.82 | $269.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $426.58 Typical High $1,000.00 | Professional | 50 · Both sides | $331.13 | $426.58 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $109.65 Median $144.54 Typical High $338.84 | Professional | 51 · Multiple procedures | $109.65 | $144.54 | $338.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $43.65 Median $57.54 Typical High $134.90 | Professional | 80 · Assistant surgeon | $43.65 | $57.54 | $134.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $30.90 Median $39.81 Typical High $93.33 | Professional | 81 · Minimal assistant surgeon | $30.90 | $39.81 | $93.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.90 Median $39.81 Typical High $93.33 | Professional | 82 · Assistant surgeon, no resident | $30.90 | $39.81 | $93.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $30.90 Median $39.81 Typical High $93.33 | Professional | AS · PA/NP assist | $30.90 | $39.81 | $93.33 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $169.82 Median $173.78 Typical High $407.38 | Professional | TC · Technical part | $169.82 | $173.78 | $407.38 |
Where South Carolina sits
The same service costs 2.4 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· 39th of 51
$200
HI $380DE $158
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.