How much rates vary
Facilitymedian $912 · 10th to 90th $724 to $1,660Professionalmedian $955 · 10th to 90th $724 to $1,660
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 $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier None (both parts) Typical Low $724.44 Median $724.44 Typical High $1,023.29 | Professional | None (both parts) | $724.44 | $724.44 | $1,023.29 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,513.56 | $1,659.59 | $1,659.59 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $954.99 Median $1,380.38 Typical High $1,659.59 | Professional | None (both parts) | $954.99 | $1,380.38 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Professional Modifier None (both parts) Typical Low $660.69 Median $660.69 Typical High $977.24 | Professional | None (both parts) | $660.69 | $660.69 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $870.96 | Professional | None | $851.14 | $851.14 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $812.83 Typical High $1,995.26 | Facility | None | $467.74 | $812.83 | $1,995.26 |
Medcost Setting Professional Modifier None (both parts) Typical Low $912.01 Median $1,174.90 Typical High $2,187.76 | Professional | None (both parts) | $912.01 | $1,174.90 | $2,187.76 |
Molina Setting Professional Modifier None (both parts) Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None (both parts) | $1,096.48 | $1,096.48 | $1,096.48 |
United Setting Facility Modifier None Typical Low $812.83 Median $954.99 Typical High $1,949.84 | Facility | None | $812.83 | $954.99 | $1,949.84 |
United Setting Professional Modifier None (both parts) Typical Low $602.56 Median $812.83 Typical High $1,096.48 | Professional | None (both parts) | $602.56 | $812.83 | $1,096.48 |
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 $363.08 Median $363.08 Typical High $512.86 | Professional | 52 · Reduced service | $363.08 | $363.08 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $208.93 | Professional | 53 · Discontinued | $147.91 | $147.91 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $154.88 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $102.33 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $102.33 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $467.74 Median $489.78 Typical High $1,148.15 | Professional | 26 · Professional part | $467.74 | $489.78 | $1,148.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,737.80 Typical High $4,365.16 | Professional | 50 · Both sides | $1,380.38 | $1,737.80 | $4,365.16 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $588.84 Typical High $1,445.44 | Professional | 51 · Multiple procedures | $457.09 | $588.84 | $1,445.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $234.42 Typical High $575.44 | Professional | 80 · Assistant surgeon | $181.97 | $234.42 | $575.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $162.18 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $128.82 | $162.18 | $407.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $162.18 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $162.18 | $407.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $162.18 Typical High $407.38 | Professional | AS · PA/NP assist | $128.82 | $162.18 | $407.38 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $707.95 Median $741.31 Typical High $1,737.80 | Professional | TC · Technical part | $707.95 | $741.31 | $1,737.80 |
Where South Carolina sits
The same service costs 3.2 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· 24th of 51
$955
HI $2,138DE $661
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.