How much rates vary
Facilitymedian $490 · 10th to 90th $295 to $661Professionalmedian $380 · 10th to 90th $295 to $661
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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None (both parts) Typical Low $295.12 Median $295.12 Typical High $416.87 | Professional | None (both parts) | $295.12 | $295.12 | $416.87 |
BCBS South Carolina Setting Facility Modifier None Typical Low $602.56 Median $660.69 Typical High $660.69 | Facility | None | $602.56 | $660.69 | $660.69 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $380.19 Median $549.54 Typical High $660.69 | Professional | None (both parts) | $380.19 | $549.54 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None (both parts) Typical Low $354.81 Median $354.81 Typical High $489.78 | Professional | None (both parts) | $354.81 | $354.81 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $457.09 | Professional | None | $436.52 | $436.52 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $354.81 Typical High $812.83 | Facility | None | $208.93 | $354.81 | $812.83 |
Medcost Setting Professional Modifier None (both parts) Typical Low $371.54 Median $467.74 Typical High $870.96 | Professional | None (both parts) | $371.54 | $467.74 | $870.96 |
Molina Setting Professional Modifier None (both parts) Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None (both parts) | $446.68 | $446.68 | $446.68 |
United Setting Facility Modifier None Typical Low $165.96 Median $323.59 Typical High $891.25 | Facility | None | $165.96 | $323.59 | $891.25 |
United Setting Professional Modifier None (both parts) Typical Low $257.04 Median $323.59 Typical High $489.78 | Professional | None (both parts) | $257.04 | $323.59 | $489.78 |
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 $147.91 Median $147.91 Typical High $208.93 | Professional | 52 · Reduced service | $147.91 | $147.91 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $83.18 | Professional | 53 · Discontinued | $58.88 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $61.66 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $41.69 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $41.69 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $186.21 Median $194.98 Typical High $467.74 | Professional | 26 · Professional part | $186.21 | $194.98 | $467.74 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $707.95 Typical High $1,737.80 | Professional | 50 · Both sides | $549.54 | $707.95 | $1,737.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $234.42 Typical High $575.44 | Professional | 51 · Multiple procedures | $181.97 | $234.42 | $575.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $93.33 Typical High $234.42 | Professional | 80 · Assistant surgeon | $74.13 | $93.33 | $234.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $51.29 Median $66.07 Typical High $162.18 | Professional | 81 · Minimal assistant surgeon | $51.29 | $66.07 | $162.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $51.29 Median $66.07 Typical High $162.18 | Professional | 82 · Assistant surgeon, no resident | $51.29 | $66.07 | $162.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $66.07 Typical High $162.18 | Professional | AS · PA/NP assist | $51.29 | $66.07 | $162.18 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $281.84 Median $295.12 Typical High $691.83 | Professional | TC · Technical part | $281.84 | $295.12 | $691.83 |
Where South Carolina sits
The same service costs 2.4 times more in Iowa than in Kansas. 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· 43rd of 51
$380
IA $776KS $324
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.