How much rates vary
Facilitymedian $275 · 10th to 90th $186 to $427Professionalmedian $245 · 10th to 90th $186 to $427
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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None (both parts) Typical Low $186.21 Median $186.21 Typical High $263.03 | Professional | None (both parts) | $186.21 | $186.21 | $263.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $380.19 Median $426.58 Typical High $426.58 | Facility | None | $380.19 | $426.58 | $426.58 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $245.47 Median $354.81 Typical High $426.58 | Professional | None (both parts) | $245.47 | $354.81 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Professional Modifier None (both parts) Typical Low $199.53 Median $199.53 Typical High $275.42 | Professional | None (both parts) | $199.53 | $199.53 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $316.23 | Professional | None | $208.93 | $208.93 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $134.90 Median $223.87 Typical High $512.86 | Facility | None | $134.90 | $223.87 | $512.86 |
Medcost Setting Professional Modifier None (both parts) Typical Low $234.42 Median $295.12 Typical High $549.54 | Professional | None (both parts) | $234.42 | $295.12 | $549.54 |
Molina Setting Professional Modifier None (both parts) Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None (both parts) | $281.84 | $281.84 | $281.84 |
United Setting Facility Modifier None Typical Low $218.78 Median $275.42 Typical High $562.34 | Facility | None | $218.78 | $275.42 | $562.34 |
United Setting Professional Modifier None (both parts) Typical Low $162.18 Median $208.93 Typical High $309.03 | Professional | None (both parts) | $162.18 | $208.93 | $309.03 |
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 $93.33 Median $93.33 Typical High $131.83 | Professional | 52 · Reduced service | $93.33 | $93.33 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $52.48 | Professional | 53 · Discontinued | $37.15 | $37.15 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $39.81 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $26.30 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $26.30 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $120.23 Median $125.89 Typical High $295.12 | Professional | 26 · Professional part | $120.23 | $125.89 | $295.12 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $446.68 Typical High $1,096.48 | Professional | 50 · Both sides | $354.81 | $446.68 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $117.49 Median $147.91 Typical High $371.54 | Professional | 51 · Multiple procedures | $117.49 | $147.91 | $371.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $46.77 Median $60.26 Typical High $147.91 | Professional | 80 · Assistant surgeon | $46.77 | $60.26 | $147.91 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.11 Median $41.69 Typical High $102.33 | Professional | 81 · Minimal assistant surgeon | $33.11 | $41.69 | $102.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.11 Median $41.69 Typical High $102.33 | Professional | 82 · Assistant surgeon, no resident | $33.11 | $41.69 | $102.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $41.69 Typical High $102.33 | Professional | AS · PA/NP assist | $33.11 | $41.69 | $102.33 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $177.83 Median $186.21 Typical High $446.68 | Professional | TC · Technical part | $177.83 | $186.21 | $446.68 |
Where South Carolina sits
The same service costs 2.9 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· 44th of 51
$245
HI $617FL $214
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.