How much rates vary
Facilitymedian $363 · 10th to 90th $251 to $575Professionalmedian $355 · 10th to 90th $251 to $575
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 $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier None (both parts) Typical Low $251.19 Median $251.19 Typical High $354.81 | Professional | None (both parts) | $251.19 | $251.19 | $354.81 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $575.44 Typical High $575.44 | Facility | None | $512.86 | $575.44 | $575.44 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $346.74 Median $354.81 Typical High $575.44 | Professional | None (both parts) | $346.74 | $354.81 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None (both parts) Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None (both parts) | $263.03 | $263.03 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $331.13 | Professional | None | $281.84 | $281.84 | $331.13 |
Medcost Setting Facility Modifier None Typical Low $162.18 Median $275.42 Typical High $691.83 | Facility | None | $162.18 | $275.42 | $691.83 |
Medcost Setting Professional Modifier None (both parts) Typical Low $316.23 Median $407.38 Typical High $741.31 | Professional | None (both parts) | $316.23 | $407.38 | $741.31 |
Molina Setting Professional Modifier None (both parts) Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None (both parts) | $380.19 | $380.19 | $380.19 |
United Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
United Setting Professional Modifier None (both parts) Typical Low $208.93 Median $281.84 Typical High $371.54 | Professional | None (both parts) | $208.93 | $281.84 | $371.54 |
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 $125.89 Median $125.89 Typical High $177.83 | Professional | 52 · Reduced service | $125.89 | $125.89 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $70.79 | Professional | 53 · Discontinued | $50.12 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $53.70 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $35.48 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $35.48 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $162.18 Median $169.82 Typical High $398.11 | Professional | 26 · Professional part | $162.18 | $169.82 | $398.11 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $602.56 Typical High $1,479.11 | Professional | 50 · Both sides | $467.74 | $602.56 | $1,479.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $204.17 Typical High $501.19 | Professional | 51 · Multiple procedures | $158.49 | $204.17 | $501.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $63.10 Median $81.28 Typical High $199.53 | Professional | 80 · Assistant surgeon | $63.10 | $81.28 | $199.53 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $43.65 Median $56.23 Typical High $138.04 | Professional | 81 · Minimal assistant surgeon | $43.65 | $56.23 | $138.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $43.65 Median $56.23 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $43.65 | $56.23 | $138.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $43.65 Median $56.23 Typical High $138.04 | Professional | AS · PA/NP assist | $43.65 | $56.23 | $138.04 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $239.88 Median $251.19 Typical High $602.56 | Professional | TC · Technical part | $239.88 | $251.19 | $602.56 |
Where South Carolina sits
The same service costs 2.2 times more in Montana 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· 25th of 51
$355
MT $575DE $263
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.