How much rates vary
Facilitymedian $151 · 10th to 90th $120 to $245Professionalmedian $126 · 10th to 90th $112 to $245
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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None (both parts) Typical Low $120.23 Median $120.23 Typical High $158.49 | Professional | None (both parts) | $120.23 | $120.23 | $158.49 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None (both parts) | $199.53 | $199.53 | $199.53 |
BCBS South Carolina Setting Facility Modifier None Typical Low $218.78 Median $245.47 Typical High $245.47 | Facility | None | $218.78 | $245.47 | $245.47 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $125.89 Median $181.97 Typical High $245.47 | Professional | None (both parts) | $125.89 | $181.97 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $154.88 | Facility | None | $151.36 | $151.36 | $154.88 |
Cigna Setting Professional Modifier None (both parts) Typical Low $112.20 Median $112.20 Typical High $154.88 | Professional | None (both parts) | $112.20 | $112.20 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Medcost Setting Facility Modifier None Typical Low $69.18 Median $134.90 Typical High $295.12 | Facility | None | $69.18 | $134.90 | $295.12 |
Medcost Setting Professional Modifier None (both parts) Typical Low $138.04 Median $181.97 Typical High $323.59 | Professional | None (both parts) | $138.04 | $181.97 | $323.59 |
United Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
United Setting Professional Modifier None (both parts) Typical Low $81.28 Median $117.49 Typical High $144.54 | Professional | None (both parts) | $81.28 | $117.49 | $144.54 |
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 $58.88 Median $58.88 Typical High $72.44 | Professional | 52 · Reduced service | $58.88 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $28.84 | Professional | 53 · Discontinued | $23.99 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $21.88 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $14.45 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $69.18 Median $72.44 Typical High $169.82 | Professional | 26 · Professional part | $69.18 | $72.44 | $169.82 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $269.15 Typical High $630.96 | Professional | 50 · Both sides | $208.93 | $269.15 | $630.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $91.20 Typical High $213.80 | Professional | 51 · Multiple procedures | $69.18 | $91.20 | $213.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $27.54 Median $36.31 Typical High $85.11 | Professional | 80 · Assistant surgeon | $27.54 | $36.31 | $85.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.50 Median $25.12 Typical High $60.26 | Professional | 81 · Minimal assistant surgeon | $19.50 | $25.12 | $60.26 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.50 Median $25.12 Typical High $60.26 | Professional | 82 · Assistant surgeon, no resident | $19.50 | $25.12 | $60.26 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.50 Median $25.12 Typical High $60.26 | Professional | AS · PA/NP assist | $19.50 | $25.12 | $60.26 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $107.15 Median $109.65 Typical High $257.04 | Professional | TC · Technical part | $107.15 | $109.65 | $257.04 |
Where South Carolina sits
The same service costs 2.1 times more in Hawaii than in Utah. 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· 33rd of 51
$132
HI $240UT $112
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.