How much rates vary
Facilitymedian $162 · 10th to 90th $115 to $263Professionalmedian $151 · 10th to 90th $115 to $263
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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $114.82 Median $114.82 Typical High $162.18 | Professional | None (both parts) | $114.82 | $114.82 | $162.18 |
BCBS South Carolina Setting Facility Modifier None Typical Low $239.88 Median $263.03 Typical High $263.03 | Facility | None | $239.88 | $263.03 | $263.03 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $151.36 Median $213.80 Typical High $263.03 | Professional | None (both parts) | $151.36 | $213.80 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None (both parts) Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | None (both parts) | $117.49 | $117.49 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $173.78 Typical High $173.78 | Professional | None | $154.88 | $173.78 | $173.78 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $125.89 Typical High $316.23 | Facility | None | $83.18 | $125.89 | $316.23 |
Medcost Setting Professional Modifier None (both parts) Typical Low $144.54 Median $186.21 Typical High $346.74 | Professional | None (both parts) | $144.54 | $186.21 | $346.74 |
Molina Setting Professional Modifier None (both parts) Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None (both parts) | $173.78 | $173.78 | $173.78 |
United Setting Facility Modifier None Typical Low $104.71 Median $128.82 Typical High $354.81 | Facility | None | $104.71 | $128.82 | $354.81 |
United Setting Professional Modifier None (both parts) Typical Low $100.00 Median $128.82 Typical High $194.98 | Professional | None (both parts) | $100.00 | $128.82 | $194.98 |
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 $57.54 Median $57.54 Typical High $81.28 | Professional | 52 · Reduced service | $57.54 | $57.54 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $33.11 | Professional | 53 · Discontinued | $22.91 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $24.55 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $16.22 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $16.22 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $74.13 Median $77.62 Typical High $181.97 | Professional | 26 · Professional part | $74.13 | $77.62 | $181.97 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $281.84 Typical High $691.83 | Professional | 50 · Both sides | $218.78 | $281.84 | $691.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $93.33 Typical High $229.09 | Professional | 51 · Multiple procedures | $72.44 | $93.33 | $229.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.84 Median $37.15 Typical High $91.20 | Professional | 80 · Assistant surgeon | $28.84 | $37.15 | $91.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $20.42 Median $26.30 Typical High $64.57 | Professional | 81 · Minimal assistant surgeon | $20.42 | $26.30 | $64.57 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $20.42 Median $26.30 Typical High $64.57 | Professional | 82 · Assistant surgeon, no resident | $20.42 | $26.30 | $64.57 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $20.42 Median $26.30 Typical High $64.57 | Professional | AS · PA/NP assist | $20.42 | $26.30 | $64.57 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $112.20 Median $117.49 Typical High $275.42 | Professional | TC · Technical part | $112.20 | $117.49 | $275.42 |
Where South Carolina sits
The same service costs 2.8 times more in Minnesota 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· 42nd of 51
$151
MN $331DE $117
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.