How much rates vary
Facilitymedian $398 · 10th to 90th $288 to $661Professionalmedian $372 · 10th to 90th $288 to $661
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 $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier None (both parts) Typical Low $288.40 Median $288.40 Typical High $478.63 | Professional | None (both parts) | $288.40 | $288.40 | $478.63 |
BCBS South Carolina Setting Facility Modifier None Typical Low $588.84 Median $660.69 Typical High $660.69 | Facility | None | $588.84 | $660.69 | $660.69 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $371.54 Median $537.03 Typical High $660.69 | Professional | None (both parts) | $371.54 | $537.03 | $660.69 |
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 $323.59 Median $323.59 Typical High $426.58 | Professional | None | $323.59 | $323.59 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $204.17 Median $338.84 Typical High $794.33 | Facility | None | $204.17 | $338.84 | $794.33 |
Medcost Setting Professional Modifier None (both parts) Typical Low $363.08 Median $457.09 Typical High $851.14 | Professional | None (both parts) | $363.08 | $457.09 | $851.14 |
Molina Setting Professional Modifier None (both parts) Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None (both parts) | $436.52 | $436.52 | $436.52 |
United Setting Facility Modifier None Typical Low $363.08 Median $851.14 Typical High $851.14 | Facility | None | $363.08 | $851.14 | $851.14 |
United Setting Professional Modifier None (both parts) Typical Low $251.19 Median $323.59 Typical High $478.63 | Professional | None (both parts) | $251.19 | $323.59 | $478.63 |
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 $144.54 Median $144.54 Typical High $204.17 | Professional | 52 · Reduced service | $144.54 | $144.54 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $81.28 | Professional | 53 · Discontinued | $57.54 | $57.54 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $61.66 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $40.74 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $40.74 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $186.21 Median $194.98 Typical High $457.09 | Professional | 26 · Professional part | $186.21 | $194.98 | $457.09 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $691.83 Typical High $1,698.24 | Professional | 50 · Both sides | $537.03 | $691.83 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $229.09 Typical High $575.44 | Professional | 51 · Multiple procedures | $181.97 | $229.09 | $575.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $91.20 Typical High $229.09 | Professional | 80 · Assistant surgeon | $72.44 | $91.20 | $229.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $64.57 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $50.12 | $64.57 | $158.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $64.57 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $64.57 | $158.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $64.57 Typical High $158.49 | Professional | AS · PA/NP assist | $50.12 | $64.57 | $158.49 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $275.42 Median $288.40 Typical High $676.08 | Professional | TC · Technical part | $275.42 | $288.40 | $676.08 |
Where South Carolina sits
The same service costs 2.8 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· 44th of 51
$372
HI $794DE $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.