How much rates vary
Facilitymedian $245 · 10th to 90th $158 to $355Professionalmedian $204 · 10th to 90th $158 to $355
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 $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None (both parts) Typical Low $158.49 Median $158.49 Typical High $223.87 | Professional | None (both parts) | $158.49 | $158.49 | $223.87 |
BCBS South Carolina Setting Facility Modifier None Typical Low $323.59 Median $354.81 Typical High $354.81 | Facility | None | $323.59 | $354.81 | $354.81 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $204.17 Median $295.12 Typical High $354.81 | Professional | None (both parts) | $204.17 | $295.12 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None (both parts) Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None (both parts) | $177.83 | $177.83 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $208.93 | Professional | None | $204.17 | $204.17 | $208.93 |
Medcost Setting Facility Modifier None Typical Low $112.20 Median $186.21 Typical High $436.52 | Facility | None | $112.20 | $186.21 | $436.52 |
Medcost Setting Professional Modifier None (both parts) Typical Low $194.98 Median $251.19 Typical High $467.74 | Professional | None (both parts) | $194.98 | $251.19 | $467.74 |
Molina Setting Professional Modifier None (both parts) Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None (both parts) | $234.42 | $234.42 | $234.42 |
United Setting Facility Modifier None Typical Low $234.42 Median $281.84 Typical High $478.63 | Facility | None | $234.42 | $281.84 | $478.63 |
United Setting Professional Modifier None (both parts) Typical Low $138.04 Median $173.78 Typical High $263.03 | Professional | None (both parts) | $138.04 | $173.78 | $263.03 |
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 $77.62 Median $77.62 Typical High $109.65 | Professional | 52 · Reduced service | $77.62 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $44.67 | Professional | 53 · Discontinued | $31.62 | $31.62 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $33.11 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $22.39 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $22.39 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $100.00 Median $104.71 Typical High $245.47 | Professional | 26 · Professional part | $100.00 | $104.71 | $245.47 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $380.19 Typical High $933.25 | Professional | 50 · Both sides | $295.12 | $380.19 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $97.72 Median $125.89 Typical High $309.03 | Professional | 51 · Multiple procedures | $97.72 | $125.89 | $309.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $50.12 Typical High $123.03 | Professional | 80 · Assistant surgeon | $39.81 | $50.12 | $123.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $27.54 Median $35.48 Typical High $87.10 | Professional | 81 · Minimal assistant surgeon | $27.54 | $35.48 | $87.10 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $27.54 Median $35.48 Typical High $87.10 | Professional | 82 · Assistant surgeon, no resident | $27.54 | $35.48 | $87.10 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $27.54 Median $35.48 Typical High $87.10 | Professional | AS · PA/NP assist | $27.54 | $35.48 | $87.10 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $151.36 Median $158.49 Typical High $371.54 | Professional | TC · Technical part | $151.36 | $158.49 | $371.54 |
Where South Carolina sits
The same service costs 3.6 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· 41st of 51
$204
HI $646TN $178
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.