How much rates vary
Facilitymedian $178 · 10th to 90th $126 to $282Professionalmedian $166 · 10th to 90th $126 to $282
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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None (both parts) Typical Low $125.89 Median $125.89 Typical High $177.83 | Professional | None (both parts) | $125.89 | $125.89 | $177.83 |
Ambetter 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 |
BCBS South Carolina Setting Facility Modifier None Typical Low $257.04 Median $281.84 Typical High $281.84 | Facility | None | $257.04 | $281.84 | $281.84 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $165.96 Median $234.42 Typical High $281.84 | Professional | None (both parts) | $165.96 | $234.42 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Professional Modifier None (both parts) Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | None (both parts) | $128.82 | $128.82 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $186.21 | Professional | None | $165.96 | $186.21 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $138.04 Typical High $346.74 | Facility | None | $89.13 | $138.04 | $346.74 |
Medcost Setting Professional Modifier None (both parts) Typical Low $158.49 Median $199.53 Typical High $371.54 | Professional | None (both parts) | $158.49 | $199.53 | $371.54 |
Molina Setting Professional Modifier None (both parts) Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None (both parts) | $186.21 | $186.21 | $186.21 |
United Setting Facility Modifier None Typical Low $186.21 Median $208.93 Typical High $380.19 | Facility | None | $186.21 | $208.93 | $380.19 |
United Setting Professional Modifier None (both parts) Typical Low $109.65 Median $138.04 Typical High $208.93 | Professional | None (both parts) | $109.65 | $138.04 | $208.93 |
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 $61.66 Median $61.66 Typical High $89.13 | Professional | 52 · Reduced service | $61.66 | $61.66 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $35.48 | Professional | 53 · Discontinued | $25.12 | $25.12 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $26.30 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $17.78 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $79.43 Median $83.18 Typical High $194.98 | Professional | 26 · Professional part | $79.43 | $83.18 | $194.98 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $234.42 Median $302.00 Typical High $741.31 | Professional | 50 · Both sides | $234.42 | $302.00 | $741.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $100.00 Typical High $245.47 | Professional | 51 · Multiple procedures | $77.62 | $100.00 | $245.47 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $39.81 Typical High $97.72 | Professional | 80 · Assistant surgeon | $31.62 | $39.81 | $97.72 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.88 Median $28.18 Typical High $69.18 | Professional | 81 · Minimal assistant surgeon | $21.88 | $28.18 | $69.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.88 Median $28.18 Typical High $69.18 | Professional | 82 · Assistant surgeon, no resident | $21.88 | $28.18 | $69.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $21.88 Median $28.18 Typical High $69.18 | Professional | AS · PA/NP assist | $21.88 | $28.18 | $69.18 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $120.23 Median $125.89 Typical High $295.12 | Professional | TC · Technical part | $120.23 | $125.89 | $295.12 |
Where South Carolina sits
The same service costs 3.5 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· 40th of 51
$166
HI $447DE $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.