How much rates vary
Facilitymedian $389 · 10th to 90th $331 to $794Professionalmedian $447 · 10th to 90th $347 to $794
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 $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None (both parts) Typical Low $346.74 Median $346.74 Typical High $489.78 | Professional | None (both parts) | $346.74 | $346.74 | $489.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $707.95 Median $794.33 Typical High $794.33 | Facility | None | $707.95 | $794.33 | $794.33 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $446.68 Median $645.65 Typical High $794.33 | Professional | None (both parts) | $446.68 | $645.65 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None (both parts) Typical Low $281.84 Median $281.84 Typical High $467.74 | Professional | None (both parts) | $281.84 | $281.84 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $371.54 | Professional | None | $346.74 | $346.74 | $371.54 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $380.19 Typical High $954.99 | Facility | None | $199.53 | $380.19 | $954.99 |
Medcost Setting Professional Modifier None (both parts) Typical Low $436.52 Median $549.54 Typical High $1,023.29 | Professional | None (both parts) | $436.52 | $549.54 | $1,023.29 |
Molina Setting Professional Modifier None (both parts) Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None (both parts) | $524.81 | $524.81 | $524.81 |
United Setting Facility Modifier None Typical Low $281.84 Median $331.13 Typical High $851.14 | Facility | None | $281.84 | $331.13 | $851.14 |
United Setting Professional Modifier None (both parts) Typical Low $257.04 Median $389.05 Typical High $478.63 | Professional | None (both parts) | $257.04 | $389.05 | $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 $173.78 Median $173.78 Typical High $239.88 | Professional | 52 · Reduced service | $173.78 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $97.72 | Professional | 53 · Discontinued | $69.18 | $69.18 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $72.44 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $47.86 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $47.86 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $223.87 Median $234.42 Typical High $549.54 | Professional | 26 · Professional part | $223.87 | $234.42 | $549.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $831.76 Typical High $2,041.74 | Professional | 50 · Both sides | $645.65 | $831.76 | $2,041.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $275.42 Typical High $676.08 | Professional | 51 · Multiple procedures | $218.78 | $275.42 | $676.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $109.65 Typical High $275.42 | Professional | 80 · Assistant surgeon | $87.10 | $109.65 | $275.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $60.26 Median $77.62 Typical High $190.55 | Professional | 81 · Minimal assistant surgeon | $60.26 | $77.62 | $190.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $60.26 Median $77.62 Typical High $190.55 | Professional | 82 · Assistant surgeon, no resident | $60.26 | $77.62 | $190.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $77.62 Typical High $190.55 | Professional | AS · PA/NP assist | $60.26 | $77.62 | $190.55 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $331.13 Median $346.74 Typical High $812.83 | Professional | TC · Technical part | $331.13 | $346.74 | $812.83 |
Where South Carolina sits
The same service costs 2.6 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· 29th of 51
$447
HI $724DE $282
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.