How much rates vary
Facilitymedian $123 · 10th to 90th $89 to $204Professionalmedian $120 · 10th to 90th $89 to $204
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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None (both parts) Typical Low $89.13 Median $89.13 Typical High $125.89 | Professional | None (both parts) | $89.13 | $89.13 | $125.89 |
BCBS South Carolina Setting Facility Modifier None Typical Low $186.21 Median $204.17 Typical High $204.17 | Facility | None | $186.21 | $204.17 | $204.17 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $120.23 Median $173.78 Typical High $204.17 | Professional | None (both parts) | $120.23 | $173.78 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None (both parts) Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None (both parts) | $89.13 | $89.13 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $138.04 | Professional | None | $131.83 | $131.83 | $138.04 |
Medcost Setting Facility Modifier None Typical Low $63.10 Median $100.00 Typical High $245.47 | Facility | None | $63.10 | $100.00 | $245.47 |
Medcost Setting Professional Modifier None (both parts) Typical Low $112.20 Median $144.54 Typical High $269.15 | Professional | None (both parts) | $112.20 | $144.54 | $269.15 |
Molina Setting Professional Modifier None (both parts) Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None (both parts) | $134.90 | $134.90 | $134.90 |
United Setting Facility Modifier None Typical Low $107.15 Median $131.83 Typical High $269.15 | Facility | None | $107.15 | $131.83 | $269.15 |
United Setting Professional Modifier None (both parts) Typical Low $77.62 Median $100.00 Typical High $147.91 | Professional | None (both parts) | $77.62 | $100.00 | $147.91 |
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 $44.67 Median $44.67 Typical High $63.10 | Professional | 52 · Reduced service | $44.67 | $44.67 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $25.70 | Professional | 53 · Discontinued | $17.78 | $17.78 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $19.05 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $12.59 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $57.54 Median $60.26 Typical High $141.25 | Professional | 26 · Professional part | $57.54 | $60.26 | $141.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $213.80 Typical High $537.03 | Professional | 50 · Both sides | $169.82 | $213.80 | $537.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $56.23 Median $72.44 Typical High $177.83 | Professional | 51 · Multiple procedures | $56.23 | $72.44 | $177.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.39 Median $28.84 Typical High $70.79 | Professional | 80 · Assistant surgeon | $22.39 | $28.84 | $70.79 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.85 Median $19.95 Typical High $50.12 | Professional | 81 · Minimal assistant surgeon | $15.85 | $19.95 | $50.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.85 Median $19.95 Typical High $50.12 | Professional | 82 · Assistant surgeon, no resident | $15.85 | $19.95 | $50.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.85 Median $19.95 Typical High $50.12 | Professional | AS · PA/NP assist | $15.85 | $19.95 | $50.12 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $87.10 Median $91.20 Typical High $213.80 | Professional | TC · Technical part | $87.10 | $91.20 | $213.80 |
Where South Carolina sits
The same service costs 3.0 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· 38th of 51
$120
HI $275DE $93.33
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.