How much rates vary
Facilitymedian $245 · 10th to 90th $170 to $389Professionalmedian $224 · 10th to 90th $170 to $389
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 $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $169.82 Median $169.82 Typical High $281.84 | Professional | None (both parts) | $169.82 | $169.82 | $281.84 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $190.55 Median $190.55 Typical High $389.05 | Professional | None (both parts) | $190.55 | $190.55 | $389.05 |
BCBS South Carolina Setting Facility Modifier None Typical Low $346.74 Median $389.05 Typical High $389.05 | Facility | None | $346.74 | $389.05 | $389.05 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $223.87 Median $323.59 Typical High $389.05 | Professional | None (both parts) | $223.87 | $323.59 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None (both parts) Typical Low $181.97 Median $181.97 Typical High $245.47 | Professional | None (both parts) | $181.97 | $181.97 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $295.12 | Professional | None | $257.04 | $257.04 | $295.12 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $186.21 Typical High $467.74 | Facility | None | $123.03 | $186.21 | $467.74 |
Medcost Setting Professional Modifier None (both parts) Typical Low $213.80 Median $275.42 Typical High $512.86 | Professional | None (both parts) | $213.80 | $275.42 | $512.86 |
Molina Setting Professional Modifier None (both parts) Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None (both parts) | $257.04 | $257.04 | $257.04 |
United Setting Facility Modifier None Typical Low $190.55 Median $245.47 Typical High $512.86 | Facility | None | $190.55 | $245.47 | $512.86 |
United Setting Professional Modifier None (both parts) Typical Low $147.91 Median $190.55 Typical High $288.40 | Professional | None (both parts) | $147.91 | $190.55 | $288.40 |
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 $85.11 Median $85.11 Typical High $120.23 | Professional | 52 · Reduced service | $85.11 | $85.11 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $47.86 | Professional | 53 · Discontinued | $33.88 | $33.88 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $36.31 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $23.99 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $23.99 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $109.65 Median $114.82 Typical High $269.15 | Professional | 26 · Professional part | $109.65 | $114.82 | $269.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $426.58 Typical High $1,023.29 | Professional | 50 · Both sides | $323.59 | $426.58 | $1,023.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $141.25 Typical High $338.84 | Professional | 51 · Multiple procedures | $107.15 | $141.25 | $338.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $56.23 Typical High $134.90 | Professional | 80 · Assistant surgeon | $42.66 | $56.23 | $134.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $30.20 Median $39.81 Typical High $95.50 | Professional | 81 · Minimal assistant surgeon | $30.20 | $39.81 | $95.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.20 Median $39.81 Typical High $95.50 | Professional | 82 · Assistant surgeon, no resident | $30.20 | $39.81 | $95.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $30.20 Median $39.81 Typical High $95.50 | Professional | AS · PA/NP assist | $30.20 | $39.81 | $95.50 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $165.96 Median $173.78 Typical High $407.38 | Professional | TC · Technical part | $165.96 | $173.78 | $407.38 |
Where South Carolina sits
The same service costs 2.5 times more in Kansas than in Florida. 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· 46th of 51
$224
KS $457FL $186
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.