How much rates vary
Facilitymedian $501 · 10th to 90th $309 to $708Professionalmedian $407 · 10th to 90th $309 to $708
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 $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $309.03 Median $309.03 Typical High $436.52 | Professional | None (both parts) | $309.03 | $309.03 | $436.52 |
BCBS South Carolina Setting Facility Modifier None Typical Low $630.96 Median $707.95 Typical High $707.95 | Facility | None | $630.96 | $707.95 | $707.95 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $407.38 Median $575.44 Typical High $707.95 | Professional | None (both parts) | $407.38 | $575.44 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None (both parts) Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None (both parts) | $363.08 | $363.08 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $416.87 | Professional | None | $380.19 | $380.19 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $223.87 Median $371.54 Typical High $851.14 | Facility | None | $223.87 | $371.54 | $851.14 |
Medcost Setting Professional Modifier None (both parts) Typical Low $389.05 Median $501.19 Typical High $933.25 | Professional | None (both parts) | $389.05 | $501.19 | $933.25 |
Molina Setting Professional Modifier None (both parts) Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None (both parts) | $467.74 | $467.74 | $467.74 |
United Setting Facility Modifier None Typical Low $426.58 Median $467.74 Typical High $933.25 | Facility | None | $426.58 | $467.74 | $933.25 |
United Setting Professional Modifier None (both parts) Typical Low $269.15 Median $346.74 Typical High $524.81 | Professional | None (both parts) | $269.15 | $346.74 | $524.81 |
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 $154.88 Median $154.88 Typical High $218.78 | Professional | 52 · Reduced service | $154.88 | $154.88 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $87.10 | Professional | 53 · Discontinued | $61.66 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $66.07 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $43.65 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $43.65 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $199.53 Median $208.93 Typical High $489.78 | Professional | 26 · Professional part | $199.53 | $208.93 | $489.78 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $741.31 Typical High $1,862.09 | Professional | 50 · Both sides | $588.84 | $741.31 | $1,862.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $251.19 Typical High $616.60 | Professional | 51 · Multiple procedures | $194.98 | $251.19 | $616.60 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $100.00 Typical High $245.47 | Professional | 80 · Assistant surgeon | $77.62 | $100.00 | $245.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $54.95 Median $69.18 Typical High $173.78 | Professional | 81 · Minimal assistant surgeon | $54.95 | $69.18 | $173.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $54.95 Median $69.18 Typical High $173.78 | Professional | 82 · Assistant surgeon, no resident | $54.95 | $69.18 | $173.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $69.18 Typical High $173.78 | Professional | AS · PA/NP assist | $54.95 | $69.18 | $173.78 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $302.00 Median $316.23 Typical High $741.31 | Professional | TC · Technical part | $302.00 | $316.23 | $741.31 |
Where South Carolina sits
The same service costs 3.0 times more in Hawaii than in West Virginia. 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
$407
HI $1,072WV $363
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.