How much rates vary
Facilitymedian $380 · 10th to 90th $263 to $603Professionalmedian $339 · 10th to 90th $263 to $603
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 $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $263.03 Median $263.03 Typical High $436.52 | Professional | None (both parts) | $263.03 | $263.03 | $436.52 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None (both parts) | $630.96 | $630.96 | $630.96 |
BCBS South Carolina Setting Facility Modifier None Typical Low $537.03 Median $602.56 Typical High $602.56 | Facility | None | $537.03 | $602.56 | $602.56 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $338.84 Median $489.78 Typical High $602.56 | Professional | None (both parts) | $338.84 | $489.78 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None (both parts) Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None (both parts) | $275.42 | $275.42 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $354.81 | Professional | None | $346.74 | $346.74 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $288.40 Typical High $724.44 | Facility | None | $190.55 | $288.40 | $724.44 |
Medcost Setting Professional Modifier None (both parts) Typical Low $331.13 Median $416.87 Typical High $776.25 | Professional | None (both parts) | $331.13 | $416.87 | $776.25 |
Molina Setting Professional Modifier None (both parts) Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None (both parts) | $398.11 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $346.74 Median $389.05 Typical High $794.33 | Facility | None | $346.74 | $389.05 | $794.33 |
United Setting Professional Modifier None (both parts) Typical Low $229.09 Median $295.12 Typical High $436.52 | Professional | None (both parts) | $229.09 | $295.12 | $436.52 |
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 $131.83 Median $131.83 Typical High $186.21 | Professional | 52 · Reduced service | $131.83 | $131.83 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $74.13 | Professional | 53 · Discontinued | $52.48 | $52.48 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $56.23 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $37.15 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $37.15 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $169.82 Median $177.83 Typical High $416.87 | Professional | 26 · Professional part | $169.82 | $177.83 | $416.87 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $630.96 Typical High $1,548.82 | Professional | 50 · Both sides | $489.78 | $630.96 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $208.93 Typical High $512.86 | Professional | 51 · Multiple procedures | $165.96 | $208.93 | $512.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $83.18 Typical High $208.93 | Professional | 80 · Assistant surgeon | $66.07 | $83.18 | $208.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $45.71 Median $58.88 Typical High $144.54 | Professional | 81 · Minimal assistant surgeon | $45.71 | $58.88 | $144.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $45.71 Median $58.88 Typical High $144.54 | Professional | 82 · Assistant surgeon, no resident | $45.71 | $58.88 | $144.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $58.88 Typical High $144.54 | Professional | AS · PA/NP assist | $45.71 | $58.88 | $144.54 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $251.19 Median $263.03 Typical High $616.60 | Professional | TC · Technical part | $251.19 | $263.03 | $616.60 |
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· 43rd of 51
$339
HI $871DE $275
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.