How much rates vary
Facilitymedian $245 · 10th to 90th $174 to $407Professionalmedian $234 · 10th to 90th $178 to $407
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 $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $177.83 Median $177.83 Typical High $251.19 | Professional | None (both parts) | $177.83 | $177.83 | $251.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $371.54 Median $407.38 Typical High $407.38 | Facility | None | $371.54 | $407.38 | $407.38 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $234.42 Median $338.84 Typical High $407.38 | Professional | None (both parts) | $234.42 | $338.84 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None (both parts) Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None (both parts) | $177.83 | $177.83 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $218.78 | Professional | None | $204.17 | $218.78 | $218.78 |
Medcost Setting Facility Modifier None Typical Low $107.15 Median $194.98 Typical High $489.78 | Facility | None | $107.15 | $194.98 | $489.78 |
Medcost Setting Professional Modifier None (both parts) Typical Low $223.87 Median $288.40 Typical High $537.03 | Professional | None (both parts) | $223.87 | $288.40 | $537.03 |
Molina Setting Professional Modifier None (both parts) Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None (both parts) | $269.15 | $269.15 | $269.15 |
United Setting Facility Modifier None Typical Low $169.82 Median $173.78 Typical High $457.09 | Facility | None | $169.82 | $173.78 | $457.09 |
United Setting Professional Modifier None (both parts) Typical Low $141.25 Median $199.53 Typical High $251.19 | Professional | None (both parts) | $141.25 | $199.53 | $251.19 |
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 $89.13 Median $89.13 Typical High $125.89 | Professional | 52 · Reduced service | $89.13 | $89.13 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $51.29 | Professional | 53 · Discontinued | $35.48 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $38.02 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $25.12 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $25.12 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $114.82 Median $120.23 Typical High $281.84 | Professional | 26 · Professional part | $114.82 | $120.23 | $281.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $426.58 Typical High $1,071.52 | Professional | 50 · Both sides | $338.84 | $426.58 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $112.20 Median $144.54 Typical High $354.81 | Professional | 51 · Multiple procedures | $112.20 | $144.54 | $354.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $44.67 Median $57.54 Typical High $141.25 | Professional | 80 · Assistant surgeon | $44.67 | $57.54 | $141.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $31.62 Median $39.81 Typical High $100.00 | Professional | 81 · Minimal assistant surgeon | $31.62 | $39.81 | $100.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $31.62 Median $39.81 Typical High $100.00 | Professional | 82 · Assistant surgeon, no resident | $31.62 | $39.81 | $100.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $39.81 Typical High $100.00 | Professional | AS · PA/NP assist | $31.62 | $39.81 | $100.00 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $173.78 Median $181.97 Typical High $426.58 | Professional | TC · Technical part | $173.78 | $181.97 | $426.58 |
Where South Carolina sits
The same service costs 2.3 times more in Wisconsin than in Colorado. 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· 28th of 51
$234
WI $407CO $178
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.