How much rates vary
Facilitymedian $617 · 10th to 90th $389 to $891Professionalmedian $513 · 10th to 90th $389 to $891
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 $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier None (both parts) Typical Low $389.05 Median $389.05 Typical High $549.54 | Professional | None (both parts) | $389.05 | $389.05 | $549.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $812.83 Median $891.25 Typical High $891.25 | Facility | None | $812.83 | $891.25 | $891.25 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $512.86 Median $741.31 Typical High $891.25 | Professional | None (both parts) | $512.86 | $741.31 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Professional Modifier None (both parts) Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | None (both parts) | $446.68 | $446.68 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $524.81 | Professional | None | $478.63 | $478.63 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $281.84 Median $426.58 Typical High $1,071.52 | Facility | None | $281.84 | $426.58 | $1,071.52 |
Medcost Setting Professional Modifier None (both parts) Typical Low $489.78 Median $630.96 Typical High $1,174.90 | Professional | None (both parts) | $489.78 | $630.96 | $1,174.90 |
Molina Setting Professional Modifier None (both parts) Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None (both parts) | $588.84 | $588.84 | $588.84 |
United Setting Facility Modifier None Typical Low $588.84 Median $707.95 Typical High $1,202.26 | Facility | None | $588.84 | $707.95 | $1,202.26 |
United Setting Professional Modifier None (both parts) Typical Low $338.84 Median $436.52 Typical High $660.69 | Professional | None (both parts) | $338.84 | $436.52 | $660.69 |
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 $194.98 Median $194.98 Typical High $275.42 | Professional | 52 · Reduced service | $194.98 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $109.65 | Professional | 53 · Discontinued | $77.62 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $83.18 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $54.95 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $263.03 Typical High $616.60 | Professional | 26 · Professional part | $251.19 | $263.03 | $616.60 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $933.25 Typical High $2,344.23 | Professional | 50 · Both sides | $741.31 | $933.25 | $2,344.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $245.47 Median $316.23 Typical High $776.25 | Professional | 51 · Multiple procedures | $245.47 | $316.23 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $125.89 Typical High $309.03 | Professional | 80 · Assistant surgeon | $97.72 | $125.89 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $69.18 Median $87.10 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $69.18 | $87.10 | $218.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $69.18 Median $87.10 Typical High $218.78 | Professional | 82 · Assistant surgeon, no resident | $69.18 | $87.10 | $218.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $87.10 Typical High $218.78 | Professional | AS · PA/NP assist | $69.18 | $87.10 | $218.78 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $380.19 Median $398.11 Typical High $933.25 | Professional | TC · Technical part | $380.19 | $398.11 | $933.25 |
Where South Carolina sits
The same service costs 3.7 times more in Hawaii than in Tennessee. 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· 42nd of 51
$513
HI $1,660TN $447
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.