How much rates vary
Facilitymedian $269 · 10th to 90th $162 to $363Professionalmedian $209 · 10th to 90th $162 to $363
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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None (both parts) Typical Low $162.18 Median $162.18 Typical High $229.09 | Professional | None (both parts) | $162.18 | $162.18 | $229.09 |
BCBS South Carolina Setting Facility Modifier None Typical Low $331.13 Median $363.08 Typical High $363.08 | Facility | None | $331.13 | $363.08 | $363.08 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $208.93 Median $302.00 Typical High $363.08 | Professional | None (both parts) | $208.93 | $302.00 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None (both parts) Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None (both parts) | $199.53 | $199.53 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $229.09 | Professional | None | $181.97 | $181.97 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $177.83 Typical High $446.68 | Facility | None | $109.65 | $177.83 | $446.68 |
Medcost Setting Professional Modifier None (both parts) Typical Low $204.17 Median $257.04 Typical High $478.63 | Professional | None (both parts) | $204.17 | $257.04 | $478.63 |
Molina Setting Professional Modifier None (both parts) Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None (both parts) | $245.47 | $245.47 | $245.47 |
United Setting Facility Modifier None Typical Low $158.49 Median $173.78 Typical High $457.09 | Facility | None | $158.49 | $173.78 | $457.09 |
United Setting Professional Modifier None (both parts) Typical Low $141.25 Median $177.83 Typical High $251.19 | Professional | None (both parts) | $141.25 | $177.83 | $251.19 |
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 $81.28 Median $81.28 Typical High $114.82 | Professional | 52 · Reduced service | $81.28 | $81.28 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $45.71 | Professional | 53 · Discontinued | $32.36 | $32.36 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $33.88 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $22.91 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $102.33 Median $107.15 Typical High $257.04 | Professional | 26 · Professional part | $102.33 | $107.15 | $257.04 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $389.05 Typical High $954.99 | Professional | 50 · Both sides | $302.00 | $389.05 | $954.99 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $100.00 Median $128.82 Typical High $316.23 | Professional | 51 · Multiple procedures | $100.00 | $128.82 | $316.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $51.29 Typical High $125.89 | Professional | 80 · Assistant surgeon | $40.74 | $51.29 | $125.89 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.18 Median $36.31 Typical High $89.13 | Professional | 81 · Minimal assistant surgeon | $28.18 | $36.31 | $89.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $28.18 Median $36.31 Typical High $89.13 | Professional | 82 · Assistant surgeon, no resident | $28.18 | $36.31 | $89.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $28.18 Median $36.31 Typical High $89.13 | Professional | AS · PA/NP assist | $28.18 | $36.31 | $89.13 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $154.88 Median $162.18 Typical High $380.19 | Professional | TC · Technical part | $154.88 | $162.18 | $380.19 |
Where South Carolina sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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
$209
WI $407CO $200
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.