How much rates vary
Facilitymedian $186 · 10th to 90th $148 to $309Professionalmedian $174 · 10th to 90th $138 to $309
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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None (both parts) Typical Low $147.91 Median $147.91 Typical High $181.97 | Professional | None (both parts) | $147.91 | $147.91 | $181.97 |
BCBS South Carolina Setting Facility Modifier None Typical Low $275.42 Median $309.03 Typical High $309.03 | Facility | None | $275.42 | $309.03 | $309.03 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $173.78 Median $251.19 Typical High $309.03 | Professional | None (both parts) | $173.78 | $251.19 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Professional Modifier None (both parts) Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | None (both parts) | $138.04 | $138.04 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $181.97 | Professional | None | $154.88 | $154.88 | $181.97 |
Medcost Setting Facility Modifier None Typical Low $97.72 Median $177.83 Typical High $371.54 | Facility | None | $97.72 | $177.83 | $371.54 |
Medcost Setting Professional Modifier None (both parts) Typical Low $169.82 Median $213.80 Typical High $398.11 | Professional | None (both parts) | $169.82 | $213.80 | $398.11 |
Molina Setting Professional Modifier None (both parts) Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None (both parts) | $204.17 | $204.17 | $204.17 |
United Setting Facility Modifier None Typical Low $199.53 Median $263.03 Typical High $407.38 | Facility | None | $199.53 | $263.03 | $407.38 |
United Setting Professional Modifier None (both parts) Typical Low $114.82 Median $151.36 Typical High $190.55 | Professional | None (both parts) | $114.82 | $151.36 | $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 $74.13 Median $74.13 Typical High $91.20 | Professional | 52 · Reduced service | $74.13 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $36.31 | Professional | 53 · Discontinued | $29.51 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $26.92 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $18.20 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $18.20 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $87.10 Median $91.20 Typical High $213.80 | Professional | 26 · Professional part | $87.10 | $91.20 | $213.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $251.19 Median $323.59 Typical High $794.33 | Professional | 50 · Both sides | $251.19 | $323.59 | $794.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $107.15 Typical High $269.15 | Professional | 51 · Multiple procedures | $85.11 | $107.15 | $269.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.88 Median $43.65 Typical High $107.15 | Professional | 80 · Assistant surgeon | $33.88 | $43.65 | $107.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.44 Median $30.20 Typical High $74.13 | Professional | 81 · Minimal assistant surgeon | $23.44 | $30.20 | $74.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.44 Median $30.20 Typical High $74.13 | Professional | 82 · Assistant surgeon, no resident | $23.44 | $30.20 | $74.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $23.44 Median $30.20 Typical High $74.13 | Professional | AS · PA/NP assist | $23.44 | $30.20 | $74.13 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $128.82 Median $134.90 Typical High $323.59 | Professional | TC · Technical part | $128.82 | $134.90 | $323.59 |
Where South Carolina sits
The same service costs 5.0 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· 37th of 51
$174
HI $692DE $138
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.