How much rates vary
Facilitymedian $398 · 10th to 90th $240 to $550Professionalmedian $316 · 10th to 90th $240 to $550
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 $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier None (both parts) Typical Low $239.88 Median $239.88 Typical High $338.84 | Professional | None (both parts) | $239.88 | $239.88 | $338.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $489.78 Median $549.54 Typical High $549.54 | Facility | None | $489.78 | $549.54 | $549.54 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $316.23 Median $457.09 Typical High $549.54 | Professional | None (both parts) | $316.23 | $457.09 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $288.40 Median $288.40 Typical High $398.11 | Professional | None (both parts) | $288.40 | $288.40 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | None | $309.03 | $309.03 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $173.78 Median $288.40 Typical High $660.69 | Facility | None | $173.78 | $288.40 | $660.69 |
Medcost Setting Professional Modifier None (both parts) Typical Low $302.00 Median $389.05 Typical High $724.44 | Professional | None (both parts) | $302.00 | $389.05 | $724.44 |
Molina Setting Professional Modifier None (both parts) Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None (both parts) | $363.08 | $363.08 | $363.08 |
United Setting Facility Modifier None Typical Low $281.84 Median $331.13 Typical High $724.44 | Facility | None | $281.84 | $331.13 | $724.44 |
United Setting Professional Modifier None (both parts) Typical Low $208.93 Median $269.15 Typical High $407.38 | Professional | None (both parts) | $208.93 | $269.15 | $407.38 |
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 $120.23 Median $120.23 Typical High $169.82 | Professional | 52 · Reduced service | $120.23 | $120.23 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $67.61 | Professional | 53 · Discontinued | $47.86 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $51.29 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $33.88 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $154.88 Median $162.18 Typical High $380.19 | Professional | 26 · Professional part | $154.88 | $162.18 | $380.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $575.44 Typical High $1,445.44 | Professional | 50 · Both sides | $457.09 | $575.44 | $1,445.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $151.36 Median $194.98 Typical High $478.63 | Professional | 51 · Multiple procedures | $151.36 | $194.98 | $478.63 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $77.62 Typical High $190.55 | Professional | 80 · Assistant surgeon | $60.26 | $77.62 | $190.55 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $42.66 Median $53.70 Typical High $134.90 | Professional | 81 · Minimal assistant surgeon | $42.66 | $53.70 | $134.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $42.66 Median $53.70 Typical High $134.90 | Professional | 82 · Assistant surgeon, no resident | $42.66 | $53.70 | $134.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $53.70 Typical High $134.90 | Professional | AS · PA/NP assist | $42.66 | $53.70 | $134.90 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $229.09 Median $245.47 Typical High $575.44 | Professional | TC · Technical part | $229.09 | $245.47 | $575.44 |
Where South Carolina sits
The same service costs 2.6 times more in Hawaii than in Washington, DC. 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
$316
HI $741DC $288
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.