How much rates vary
Facilitymedian $170 · 10th to 90th $91 to $209Professionalmedian $123 · 10th to 90th $91 to $209
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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None (both parts) Typical Low $91.20 Median $91.20 Typical High $128.82 | Professional | None (both parts) | $91.20 | $91.20 | $128.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $186.21 Median $208.93 Typical High $208.93 | Facility | None | $186.21 | $208.93 | $208.93 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $120.23 Median $173.78 Typical High $208.93 | Professional | None (both parts) | $120.23 | $173.78 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None (both parts) Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None (both parts) | $123.03 | $123.03 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | None | $109.65 | $109.65 | $123.03 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $109.65 Typical High $251.19 | Facility | None | $66.07 | $109.65 | $251.19 |
Medcost Setting Professional Modifier None (both parts) Typical Low $114.82 Median $147.91 Typical High $269.15 | Professional | None (both parts) | $114.82 | $147.91 | $269.15 |
Molina Setting Professional Modifier None (both parts) Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None (both parts) | $138.04 | $138.04 | $138.04 |
United Setting Facility Modifier None Typical Low $107.15 Median $134.90 Typical High $275.42 | Facility | None | $107.15 | $134.90 | $275.42 |
United Setting Professional Modifier None (both parts) Typical Low $79.43 Median $102.33 Typical High $154.88 | Professional | None (both parts) | $79.43 | $102.33 | $154.88 |
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 $45.71 Median $45.71 Typical High $64.57 | Professional | 52 · Reduced service | $45.71 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $25.70 | Professional | 53 · Discontinued | $18.20 | $18.20 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $19.50 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $12.88 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $58.88 Median $61.66 Typical High $144.54 | Professional | 26 · Professional part | $58.88 | $61.66 | $144.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $218.78 Typical High $537.03 | Professional | 50 · Both sides | $173.78 | $218.78 | $537.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $74.13 Typical High $181.97 | Professional | 51 · Multiple procedures | $57.54 | $74.13 | $181.97 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.91 Median $29.51 Typical High $72.44 | Professional | 80 · Assistant surgeon | $22.91 | $29.51 | $72.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.22 Median $20.42 Typical High $50.12 | Professional | 81 · Minimal assistant surgeon | $16.22 | $20.42 | $50.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.22 Median $20.42 Typical High $50.12 | Professional | 82 · Assistant surgeon, no resident | $16.22 | $20.42 | $50.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.22 Median $20.42 Typical High $50.12 | Professional | AS · PA/NP assist | $16.22 | $20.42 | $50.12 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $89.13 Median $91.20 Typical High $218.78 | Professional | TC · Technical part | $89.13 | $91.20 | $218.78 |
Where South Carolina sits
The same service costs 2.7 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· 37th of 51
$123
HI $295DC $110
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.