How much rates vary
Facilitymedian $126 · 10th to 90th $100 to $245Professionalmedian $110 · 10th to 90th $95 to $209
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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None (both parts) Typical Low $100.00 Median $100.00 Typical High $154.88 | Professional | None (both parts) | $100.00 | $100.00 | $154.88 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None (both parts) | $177.83 | $177.83 | $177.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $186.21 Median $208.93 Typical High $208.93 | Facility | None | $186.21 | $208.93 | $208.93 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $100.00 Median $144.54 Typical High $208.93 | Professional | None (both parts) | $100.00 | $144.54 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $141.25 | Facility | None | $107.15 | $125.89 | $141.25 |
Cigna Setting Professional Modifier None (both parts) Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None (both parts) | $93.33 | $93.33 | $125.89 |
Medcost Setting Facility Modifier None Typical Low $100.00 Median $120.23 Typical High $251.19 | Facility | None | $100.00 | $120.23 | $251.19 |
Medcost Setting Professional Modifier None (both parts) Typical Low $158.49 Median $158.49 Typical High $269.15 | Professional | None (both parts) | $158.49 | $158.49 | $269.15 |
Molina Setting Professional Modifier None (both parts) Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None (both parts) | $138.04 | $138.04 | $138.04 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier None (both parts) Typical Low $70.79 Median $100.00 Typical High $141.25 | Professional | None (both parts) | $70.79 | $100.00 | $141.25 |
13 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 $50.12 Median $50.12 Typical High $61.66 | Professional | 52 · Reduced service | $50.12 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $24.55 | Professional | 53 · Discontinued | $19.95 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $18.20 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $12.30 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | RR · Rental | $10.72 | $10.72 | $12.59 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $63.10 Median $63.10 Typical High $144.54 | Professional | 26 · Professional part | $63.10 | $63.10 | $144.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $239.88 Typical High $537.03 | Professional | 50 · Both sides | $239.88 | $239.88 | $537.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $79.43 Median $79.43 Typical High $181.97 | Professional | 51 · Multiple procedures | $79.43 | $79.43 | $181.97 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $31.62 Typical High $72.44 | Professional | 80 · Assistant surgeon | $31.62 | $31.62 | $72.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $22.39 Median $22.39 Typical High $50.12 | Professional | 81 · Minimal assistant surgeon | $22.39 | $22.39 | $50.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $22.39 Median $22.39 Typical High $50.12 | Professional | 82 · Assistant surgeon, no resident | $22.39 | $22.39 | $50.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $22.39 Median $22.39 Typical High $50.12 | Professional | AS · PA/NP assist | $22.39 | $22.39 | $50.12 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $95.50 Median $95.50 Typical High $213.80 | Professional | TC · Technical part | $95.50 | $95.50 | $213.80 |
Where South Carolina sits
The same service costs 2.1 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· 40th of 51
$112
HI $200DE $93.33
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.