How much rates vary
Facilitymedian $447 · 10th to 90th $398 to $813Professionalmedian $468 · 10th to 90th $363 to $813
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 $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None (both parts) Typical Low $398.11 Median $398.11 Typical High $478.63 | Professional | None (both parts) | $398.11 | $398.11 | $478.63 |
BCBS South Carolina Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $812.83 | Facility | None | $724.44 | $812.83 | $812.83 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $467.74 Median $660.69 Typical High $812.83 | Professional | None (both parts) | $467.74 | $660.69 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None (both parts) Typical Low $331.13 Median $331.13 Typical High $478.63 | Professional | None (both parts) | $331.13 | $331.13 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $457.09 | Professional | None | $416.87 | $416.87 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $234.42 Median $436.52 Typical High $977.24 | Facility | None | $234.42 | $436.52 | $977.24 |
Medcost Setting Professional Modifier None (both parts) Typical Low $446.68 Median $575.44 Typical High $1,071.52 | Professional | None (both parts) | $446.68 | $575.44 | $1,071.52 |
Molina Setting Professional Modifier None (both parts) Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None (both parts) | $537.03 | $537.03 | $537.03 |
United Setting Facility Modifier None Typical Low $478.63 Median $630.96 Typical High $977.24 | Facility | None | $478.63 | $630.96 | $977.24 |
United 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 |
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 $199.53 Median $199.53 Typical High $239.88 | Professional | 52 · Reduced service | $199.53 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $95.50 | Professional | 53 · Discontinued | $79.43 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $72.44 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $47.86 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $47.86 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $229.09 Median $239.88 Typical High $562.34 | Professional | 26 · Professional part | $229.09 | $239.88 | $562.34 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $851.14 Typical High $2,137.96 | Professional | 50 · Both sides | $676.08 | $851.14 | $2,137.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $288.40 Typical High $707.95 | Professional | 51 · Multiple procedures | $223.87 | $288.40 | $707.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $114.82 Typical High $281.84 | Professional | 80 · Assistant surgeon | $89.13 | $114.82 | $281.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $63.10 Median $79.43 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $63.10 | $79.43 | $199.53 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $63.10 Median $79.43 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $63.10 | $79.43 | $199.53 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $79.43 Typical High $199.53 | Professional | AS · PA/NP assist | $63.10 | $79.43 | $199.53 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $346.74 Median $363.08 Typical High $851.14 | Professional | TC · Technical part | $346.74 | $363.08 | $851.14 |
Where South Carolina sits
The same service costs 4.6 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· 26th of 51
$468
HI $1,514DE $331
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.