How much rates vary
Facilitymedian $174 · 10th to 90th $102 to $234Professionalmedian $135 · 10th to 90th $102 to $234
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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None (both parts) Typical Low $102.33 Median $102.33 Typical High $144.54 | Professional | None (both parts) | $102.33 | $102.33 | $144.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $208.93 Median $234.42 Typical High $234.42 | Facility | None | $208.93 | $234.42 | $234.42 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $134.90 Median $194.98 Typical High $234.42 | Professional | None (both parts) | $134.90 | $194.98 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None (both parts) Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | None (both parts) | $128.82 | $128.82 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $147.91 | Professional | None | $117.49 | $117.49 | $147.91 |
Medcost Setting Facility Modifier None Typical Low $67.61 Median $112.20 Typical High $281.84 | Facility | None | $67.61 | $112.20 | $281.84 |
Medcost Setting Professional Modifier None (both parts) Typical Low $128.82 Median $165.96 Typical High $309.03 | Professional | None (both parts) | $128.82 | $165.96 | $309.03 |
Molina Setting Professional Modifier None (both parts) Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None (both parts) | $154.88 | $154.88 | $154.88 |
United Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $281.84 | Facility | None | $85.11 | $109.65 | $281.84 |
United Setting Professional Modifier None (both parts) Typical Low $87.10 Median $114.82 Typical High $158.49 | Professional | None (both parts) | $87.10 | $114.82 | $158.49 |
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 $51.29 Median $51.29 Typical High $72.44 | Professional | 52 · Reduced service | $51.29 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $28.84 | Professional | 53 · Discontinued | $20.42 | $20.42 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $21.88 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $14.45 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $66.07 Median $69.18 Typical High $162.18 | Professional | 26 · Professional part | $66.07 | $69.18 | $162.18 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $245.47 Typical High $616.60 | Professional | 50 · Both sides | $194.98 | $245.47 | $616.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $64.57 Median $83.18 Typical High $204.17 | Professional | 51 · Multiple procedures | $64.57 | $83.18 | $204.17 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.70 Median $33.11 Typical High $81.28 | Professional | 80 · Assistant surgeon | $25.70 | $33.11 | $81.28 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $18.20 Median $22.91 Typical High $57.54 | Professional | 81 · Minimal assistant surgeon | $18.20 | $22.91 | $57.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $18.20 Median $22.91 Typical High $57.54 | Professional | 82 · Assistant surgeon, no resident | $18.20 | $22.91 | $57.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $18.20 Median $22.91 Typical High $57.54 | Professional | AS · PA/NP assist | $18.20 | $22.91 | $57.54 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $100.00 Median $104.71 Typical High $245.47 | Professional | TC · Technical part | $100.00 | $104.71 | $245.47 |
Where South Carolina sits
The same service costs 2.0 times more in Wisconsin 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· 38th of 51
$135
WI $257DE $129
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.