How much rates vary
Facilitymedian $398 · 10th to 90th $234 to $537Professionalmedian $316 · 10th to 90th $234 to $537
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 $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None (both parts) Typical Low $234.42 Median $234.42 Typical High $331.13 | Professional | None (both parts) | $234.42 | $234.42 | $331.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $489.78 Median $537.03 Typical High $537.03 | Facility | None | $489.78 | $537.03 | $537.03 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $316.23 Median $457.09 Typical High $537.03 | Professional | None (both parts) | $316.23 | $457.09 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None (both parts) | $295.12 | $295.12 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | None | $302.00 | $302.00 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $257.04 Typical High $645.65 | Facility | None | $169.82 | $257.04 | $645.65 |
Medcost Setting Professional Modifier None (both parts) Typical Low $295.12 Median $380.19 Typical High $707.95 | Professional | None (both parts) | $295.12 | $380.19 | $707.95 |
Molina Setting Professional Modifier None (both parts) Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None (both parts) | $354.81 | $354.81 | $354.81 |
United Setting Facility Modifier None Typical Low $257.04 Median $331.13 Typical High $724.44 | Facility | None | $257.04 | $331.13 | $724.44 |
United Setting Professional Modifier None (both parts) Typical Low $204.17 Median $263.03 Typical High $398.11 | Professional | None (both parts) | $204.17 | $263.03 | $398.11 |
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 $117.49 Median $117.49 Typical High $165.96 | Professional | 52 · Reduced service | $117.49 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $66.07 | Professional | 53 · Discontinued | $46.77 | $46.77 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $50.12 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $33.11 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $33.11 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $151.36 Median $158.49 Typical High $371.54 | Professional | 26 · Professional part | $151.36 | $158.49 | $371.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $562.34 Typical High $1,412.54 | Professional | 50 · Both sides | $446.68 | $562.34 | $1,412.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $147.91 Median $190.55 Typical High $467.74 | Professional | 51 · Multiple procedures | $147.91 | $190.55 | $467.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $75.86 Typical High $186.21 | Professional | 80 · Assistant surgeon | $58.88 | $75.86 | $186.21 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $41.69 Median $52.48 Typical High $131.83 | Professional | 81 · Minimal assistant surgeon | $41.69 | $52.48 | $131.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $41.69 Median $52.48 Typical High $131.83 | Professional | 82 · Assistant surgeon, no resident | $41.69 | $52.48 | $131.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $52.48 Typical High $131.83 | Professional | AS · PA/NP assist | $41.69 | $52.48 | $131.83 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $229.09 Median $239.88 Typical High $562.34 | Professional | TC · Technical part | $229.09 | $239.88 | $562.34 |
Where South Carolina sits
The same service costs 2.5 times more in Hawaii than in Washington, DC. 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
$316
HI $708DC $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.