How much rates vary
Facilitymedian $316 · 10th to 90th $200 to $457Professionalmedian $263 · 10th to 90th $200 to $457
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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None (both parts) Typical Low $199.53 Median $199.53 Typical High $288.40 | Professional | None (both parts) | $199.53 | $199.53 | $288.40 |
BCBS South Carolina Setting Facility Modifier None Typical Low $416.87 Median $457.09 Typical High $457.09 | Facility | None | $416.87 | $457.09 | $457.09 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $263.03 Median $380.19 Typical High $457.09 | Professional | None (both parts) | $263.03 | $380.19 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None (both parts) Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None (both parts) | $229.09 | $229.09 | $316.23 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | None | $257.04 | $257.04 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $223.87 Typical High $562.34 | Facility | None | $141.25 | $223.87 | $562.34 |
Medcost Setting Professional Modifier None (both parts) Typical Low $251.19 Median $323.59 Typical High $602.56 | Professional | None (both parts) | $251.19 | $323.59 | $602.56 |
Molina Setting Professional Modifier None (both parts) Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None (both parts) | $302.00 | $302.00 | $302.00 |
United Setting Facility Modifier None Typical Low $213.80 Median $257.04 Typical High $602.56 | Facility | None | $213.80 | $257.04 | $602.56 |
United Setting Professional Modifier None (both parts) Typical Low $177.83 Median $223.87 Typical High $331.13 | Professional | None (both parts) | $177.83 | $223.87 | $331.13 |
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 $100.00 Median $100.00 Typical High $141.25 | Professional | 52 · Reduced service | $100.00 | $100.00 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $57.54 | Professional | 53 · Discontinued | $40.74 | $40.74 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $42.66 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $28.84 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $28.84 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $128.82 Median $134.90 Typical High $316.23 | Professional | 26 · Professional part | $128.82 | $134.90 | $316.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $489.78 Typical High $1,202.26 | Professional | 50 · Both sides | $380.19 | $489.78 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $162.18 Typical High $398.11 | Professional | 51 · Multiple procedures | $125.89 | $162.18 | $398.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $64.57 Typical High $158.49 | Professional | 80 · Assistant surgeon | $51.29 | $64.57 | $158.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $35.48 Median $45.71 Typical High $112.20 | Professional | 81 · Minimal assistant surgeon | $35.48 | $45.71 | $112.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $35.48 Median $45.71 Typical High $112.20 | Professional | 82 · Assistant surgeon, no resident | $35.48 | $45.71 | $112.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $45.71 Typical High $112.20 | Professional | AS · PA/NP assist | $35.48 | $45.71 | $112.20 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $194.98 Median $204.17 Typical High $478.63 | Professional | TC · Technical part | $194.98 | $204.17 | $478.63 |
Where South Carolina sits
The same service costs 2.5 times more in Hawaii 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· 39th of 51
$263
HI $562DE $229
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.