How much rates vary
Facilitymedian $151 · 10th to 90th $135 to $282Professionalmedian $174 · 10th to 90th $123 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 $204.17 | Professional | None (both parts) | $134.90 | $134.90 | $204.17 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $12.59 Median $229.09 Typical High $281.84 | Professional | None (both parts) | $12.59 | $229.09 | $281.84 |
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 $173.78 Median $251.19 Typical High $281.84 | Professional | None (both parts) | $173.78 | $251.19 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $144.54 | Facility | None | $141.25 | $141.25 | $144.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None (both parts) | $104.71 | $104.71 | $144.54 |
Medcost Setting Facility Modifier None Typical Low $134.90 Median $162.18 Typical High $338.84 | Facility | None | $134.90 | $162.18 | $338.84 |
Medcost Setting Professional Modifier None (both parts) Typical Low $213.80 Median $213.80 Typical High $371.54 | Professional | None (both parts) | $213.80 | $213.80 | $371.54 |
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 $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None (both parts) Typical Low $95.50 Median $134.90 Typical High $190.55 | Professional | None (both parts) | $95.50 | $134.90 | $190.55 |
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 $83.18 | Professional | 52 · Reduced service | $67.61 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $33.11 | Professional | 53 · Discontinued | $27.54 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $24.55 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $16.60 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $16.60 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $87.10 Median $87.10 Typical High $194.98 | Professional | 26 · Professional part | $87.10 | $87.10 | $194.98 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $323.59 Typical High $724.44 | Professional | 50 · Both sides | $323.59 | $323.59 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $107.15 Typical High $245.47 | Professional | 51 · Multiple procedures | $107.15 | $107.15 | $245.47 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $42.66 Typical High $97.72 | Professional | 80 · Assistant surgeon | $42.66 | $42.66 | $97.72 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $30.20 Median $30.20 Typical High $67.61 | Professional | 81 · Minimal assistant surgeon | $30.20 | $30.20 | $67.61 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.20 Median $30.20 Typical High $67.61 | Professional | 82 · Assistant surgeon, no resident | $30.20 | $30.20 | $67.61 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $30.20 Median $30.20 Typical High $67.61 | Professional | AS · PA/NP assist | $30.20 | $30.20 | $67.61 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $128.82 Median $128.82 Typical High $295.12 | Professional | TC · Technical part | $128.82 | $128.82 | $295.12 |
Where South Carolina sits
The same service costs 2.2 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· 26th of 51
$174
HI $275DE $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.