How much rates vary
Facilitymedian $692 · 10th to 90th $398 to $912Professionalmedian $525 · 10th to 90th $398 to $912
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 $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None (both parts) Typical Low $398.11 Median $398.11 Typical High $575.44 | Professional | None (both parts) | $398.11 | $398.11 | $575.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $831.76 Median $912.01 Typical High $912.01 | Facility | None | $831.76 | $912.01 | $912.01 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $524.81 Median $741.31 Typical High $912.01 | Professional | None (both parts) | $524.81 | $741.31 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Professional Modifier None (both parts) Typical Low $512.86 Median $512.86 Typical High $691.83 | Professional | None (both parts) | $512.86 | $512.86 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $524.81 | Professional | None | $467.74 | $467.74 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $263.03 Median $446.68 Typical High $1,096.48 | Facility | None | $263.03 | $446.68 | $1,096.48 |
Medcost Setting Professional Modifier None (both parts) Typical Low $501.19 Median $645.65 Typical High $1,202.26 | Professional | None (both parts) | $501.19 | $645.65 | $1,202.26 |
Molina Setting Professional Modifier None (both parts) Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None (both parts) | $602.56 | $602.56 | $602.56 |
United Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $1,122.02 | Facility | None | $398.11 | $501.19 | $1,122.02 |
United Setting Professional Modifier None (both parts) Typical Low $346.74 Median $446.68 Typical High $616.60 | Professional | None (both parts) | $346.74 | $446.68 | $616.60 |
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 $199.53 Median $199.53 Typical High $281.84 | Professional | 52 · Reduced service | $199.53 | $199.53 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $114.82 | Professional | 53 · Discontinued | $81.28 | $81.28 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $85.11 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $57.54 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $57.54 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $257.04 Median $269.15 Typical High $630.96 | Professional | 26 · Professional part | $257.04 | $269.15 | $630.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $954.99 Typical High $2,398.83 | Professional | 50 · Both sides | $758.58 | $954.99 | $2,398.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $251.19 Median $323.59 Typical High $794.33 | Professional | 51 · Multiple procedures | $251.19 | $323.59 | $794.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $128.82 Typical High $316.23 | Professional | 80 · Assistant surgeon | $100.00 | $128.82 | $316.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $70.79 Median $91.20 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $70.79 | $91.20 | $223.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $70.79 Median $91.20 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $70.79 | $91.20 | $223.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $91.20 Typical High $223.87 | Professional | AS · PA/NP assist | $70.79 | $91.20 | $223.87 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $389.05 Median $407.38 Typical High $954.99 | Professional | TC · Technical part | $389.05 | $407.38 | $954.99 |
Where South Carolina sits
The same service costs 2.4 times more in Hawaii than in Washington, DC. 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· 32nd of 51
$525
HI $1,122DC $468
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.