How much rates vary
Facilitymedian $282 · 10th to 90th $200 to $457Professionalmedian $257 · 10th to 90th $200 to $457
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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None (both parts) Typical Low $199.53 Median $199.53 Typical High $281.84 | Professional | None (both parts) | $199.53 | $199.53 | $281.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $407.38 Median $457.09 Typical High $457.09 | Facility | None | $407.38 | $457.09 | $457.09 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $257.04 Median $371.54 Typical High $457.09 | Professional | None (both parts) | $257.04 | $371.54 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Professional Modifier None (both parts) Typical Low $204.17 Median $204.17 Typical High $281.84 | Professional | None (both parts) | $204.17 | $204.17 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $223.87 Typical High $549.54 | Facility | None | $138.04 | $223.87 | $549.54 |
Medcost Setting Professional Modifier None (both parts) Typical Low $251.19 Median $323.59 Typical High $602.56 | Professional | None (both parts) | $251.19 | $323.59 | $602.56 |
Molina Setting Professional Modifier None (both parts) Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None (both parts) | $302.00 | $302.00 | $302.00 |
United Setting Facility Modifier None Typical Low $288.40 Median $389.05 Typical High $588.84 | Facility | None | $288.40 | $389.05 | $588.84 |
United Setting Professional Modifier None (both parts) Typical Low $173.78 Median $223.87 Typical High $323.59 | Professional | None (both parts) | $173.78 | $223.87 | $323.59 |
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 $100.00 Median $100.00 Typical High $141.25 | Professional | 52 · Reduced service | $100.00 | $100.00 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $56.23 | Professional | 53 · Discontinued | $39.81 | $39.81 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $42.66 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $28.18 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $28.18 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $128.82 Median $134.90 Typical High $316.23 | Professional | 26 · Professional part | $128.82 | $134.90 | $316.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $478.63 Typical High $1,202.26 | Professional | 50 · Both sides | $380.19 | $478.63 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $162.18 Typical High $398.11 | Professional | 51 · Multiple procedures | $125.89 | $162.18 | $398.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $64.57 Typical High $158.49 | Professional | 80 · Assistant surgeon | $50.12 | $64.57 | $158.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $35.48 Median $44.67 Typical High $112.20 | Professional | 81 · Minimal assistant surgeon | $35.48 | $44.67 | $112.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $35.48 Median $44.67 Typical High $112.20 | Professional | 82 · Assistant surgeon, no resident | $35.48 | $44.67 | $112.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $44.67 Typical High $112.20 | Professional | AS · PA/NP assist | $35.48 | $44.67 | $112.20 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $194.98 Median $204.17 Typical High $478.63 | Professional | TC · Technical part | $194.98 | $204.17 | $478.63 |
Where South Carolina sits
The same service costs 4.1 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
$257
HI $832DE $204
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.