How much rates vary
Facilitymedian $166 · 10th to 90th $95 to $214Professionalmedian $126 · 10th to 90th $95 to $214
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 $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None (both parts) Typical Low $95.50 Median $95.50 Typical High $134.90 | Professional | None (both parts) | $95.50 | $95.50 | $134.90 |
BCBS South Carolina Setting Facility Modifier None Typical Low $194.98 Median $213.80 Typical High $213.80 | Facility | None | $194.98 | $213.80 | $213.80 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $125.89 Median $177.83 Typical High $213.80 | Professional | None (both parts) | $125.89 | $177.83 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None (both parts) Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None (both parts) | $120.23 | $120.23 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $144.54 | Professional | None | $131.83 | $131.83 | $144.54 |
Medcost Setting Facility Modifier None Typical Low $67.61 Median $109.65 Typical High $263.03 | Facility | None | $67.61 | $109.65 | $263.03 |
Medcost Setting Professional Modifier None (both parts) Typical Low $120.23 Median $151.36 Typical High $281.84 | Professional | None (both parts) | $120.23 | $151.36 | $281.84 |
United Setting Facility Modifier None Typical Low $138.04 Median $141.25 Typical High $288.40 | Facility | None | $138.04 | $141.25 | $288.40 |
United Setting Professional Modifier None (both parts) Typical Low $83.18 Median $104.71 Typical High $158.49 | Professional | None (both parts) | $83.18 | $104.71 | $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 $46.77 Median $46.77 Typical High $67.61 | Professional | 52 · Reduced service | $46.77 | $46.77 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $26.92 | Professional | 53 · Discontinued | $19.05 | $19.05 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $19.95 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $13.49 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $60.26 Median $63.10 Typical High $151.36 | Professional | 26 · Professional part | $60.26 | $63.10 | $151.36 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $177.83 Median $229.09 Typical High $562.34 | Professional | 50 · Both sides | $177.83 | $229.09 | $562.34 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $58.88 Median $75.86 Typical High $186.21 | Professional | 51 · Multiple procedures | $58.88 | $75.86 | $186.21 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $23.99 Median $30.20 Typical High $74.13 | Professional | 80 · Assistant surgeon | $23.99 | $30.20 | $74.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.60 Median $21.38 Typical High $52.48 | Professional | 81 · Minimal assistant surgeon | $16.60 | $21.38 | $52.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.60 Median $21.38 Typical High $52.48 | Professional | 82 · Assistant surgeon, no resident | $16.60 | $21.38 | $52.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.60 Median $21.38 Typical High $52.48 | Professional | AS · PA/NP assist | $16.60 | $21.38 | $52.48 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $91.20 Median $95.50 Typical High $223.87 | Professional | TC · Technical part | $91.20 | $95.50 | $223.87 |
Where South Carolina sits
The same service costs 2.8 times more in Hawaii than in Florida. 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· 36th of 51
$126
HI $331FL $120
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.