How much rates vary
Facilitymedian $263 · 10th to 90th $209 to $427Professionalmedian $245 · 10th to 90th $195 to $427
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 $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None (both parts) Typical Low $208.93 Median $208.93 Typical High $281.84 | Professional | None (both parts) | $208.93 | $208.93 | $281.84 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None (both parts) | $389.05 | $389.05 | $389.05 |
BCBS South Carolina Setting Facility Modifier None Typical Low $389.05 Median $426.58 Typical High $426.58 | Facility | None | $389.05 | $426.58 | $426.58 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $245.47 Median $354.81 Typical High $426.58 | Professional | None (both parts) | $245.47 | $354.81 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None (both parts) Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | None (both parts) | $194.98 | $194.98 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $245.47 | Professional | None | $229.09 | $229.09 | $245.47 |
Medcost Setting Facility Modifier None Typical Low $131.83 Median $239.88 Typical High $524.81 | Facility | None | $131.83 | $239.88 | $524.81 |
Medcost Setting Professional Modifier None (both parts) Typical Low $234.42 Median $302.00 Typical High $562.34 | Professional | None (both parts) | $234.42 | $302.00 | $562.34 |
Molina Setting Professional Modifier None (both parts) Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None (both parts) | $281.84 | $281.84 | $281.84 |
United Setting Facility Modifier None Typical Low $213.80 Median $275.42 Typical High $562.34 | Facility | None | $213.80 | $275.42 | $562.34 |
United Setting Professional Modifier None (both parts) Typical Low $158.49 Median $208.93 Typical High $263.03 | Professional | None (both parts) | $158.49 | $208.93 | $263.03 |
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 $104.71 Median $104.71 Typical High $125.89 | Professional | 52 · Reduced service | $104.71 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $41.69 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $38.02 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $25.12 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $25.12 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $120.23 Median $125.89 Typical High $295.12 | Professional | 26 · Professional part | $120.23 | $125.89 | $295.12 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $457.09 Typical High $1,122.02 | Professional | 50 · Both sides | $354.81 | $457.09 | $1,122.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $117.49 Median $154.88 Typical High $371.54 | Professional | 51 · Multiple procedures | $117.49 | $154.88 | $371.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $60.26 Typical High $147.91 | Professional | 80 · Assistant surgeon | $47.86 | $60.26 | $147.91 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.11 Median $42.66 Typical High $104.71 | Professional | 81 · Minimal assistant surgeon | $33.11 | $42.66 | $104.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.11 Median $42.66 Typical High $104.71 | Professional | 82 · Assistant surgeon, no resident | $33.11 | $42.66 | $104.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $42.66 Typical High $104.71 | Professional | AS · PA/NP assist | $33.11 | $42.66 | $104.71 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $181.97 Median $190.55 Typical High $446.68 | Professional | TC · Technical part | $181.97 | $190.55 | $446.68 |
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· 38th of 51
$245
HI $912DE $195
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.