How much rates vary
Facilitymedian $138 · 10th to 90th $100 to $229Professionalmedian $129 · 10th to 90th $100 to $229
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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None (both parts) Typical Low $100.00 Median $100.00 Typical High $141.25 | Professional | None (both parts) | $100.00 | $100.00 | $141.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $204.17 Median $229.09 Typical High $229.09 | Facility | None | $204.17 | $229.09 | $229.09 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $128.82 Median $186.21 Typical High $229.09 | Professional | None (both parts) | $128.82 | $186.21 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None (both parts) Typical Low $102.33 Median $102.33 Typical High $138.04 | Professional | None (both parts) | $102.33 | $102.33 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $151.36 | Professional | None | $134.90 | $134.90 | $151.36 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $109.65 Typical High $275.42 | Facility | None | $70.79 | $109.65 | $275.42 |
Medcost Setting Professional Modifier None (both parts) Typical Low $125.89 Median $158.49 Typical High $295.12 | Professional | None (both parts) | $125.89 | $158.49 | $295.12 |
Molina Setting Professional Modifier None (both parts) Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None (both parts) | $151.36 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $302.00 | Facility | None | $147.91 | $154.88 | $302.00 |
United Setting Professional Modifier None (both parts) Typical Low $87.10 Median $109.65 Typical High $165.96 | Professional | None (both parts) | $87.10 | $109.65 | $165.96 |
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 $50.12 Median $50.12 Typical High $70.79 | Professional | 52 · Reduced service | $50.12 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $28.18 | Professional | 53 · Discontinued | $19.95 | $19.95 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $20.89 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $14.13 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $64.57 Median $66.07 Typical High $158.49 | Professional | 26 · Professional part | $64.57 | $66.07 | $158.49 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $239.88 Typical High $588.84 | Professional | 50 · Both sides | $186.21 | $239.88 | $588.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $79.43 Typical High $194.98 | Professional | 51 · Multiple procedures | $63.10 | $79.43 | $194.98 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $32.36 Typical High $79.43 | Professional | 80 · Assistant surgeon | $25.12 | $32.36 | $79.43 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.38 Median $22.39 Typical High $54.95 | Professional | 81 · Minimal assistant surgeon | $17.38 | $22.39 | $54.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.38 Median $22.39 Typical High $54.95 | Professional | 82 · Assistant surgeon, no resident | $17.38 | $22.39 | $54.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $22.39 Typical High $54.95 | Professional | AS · PA/NP assist | $17.38 | $22.39 | $54.95 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $95.50 Median $100.00 Typical High $234.42 | Professional | TC · Technical part | $95.50 | $100.00 | $234.42 |
Where South Carolina sits
The same service costs 3.5 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
$129
HI $363DE $102
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.