How much rates vary
Facilitymedian $1,479 · 10th to 90th $813 to $1,862Professionalmedian $1,072 · 10th to 90th $813 to $1,862
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 $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $812.83 Median $812.83 Typical High $1,148.15 | Professional | None (both parts) | $812.83 | $812.83 | $1,148.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,659.59 | $1,862.09 | $1,862.09 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,047.13 Median $1,513.56 Typical High $1,862.09 | Professional | None (both parts) | $1,047.13 | $1,513.56 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,071.52 Median $1,071.52 Typical High $1,479.11 | Professional | None (both parts) | $1,071.52 | $1,071.52 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,174.90 | Professional | None | $870.96 | $870.96 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $977.24 Typical High $2,238.72 | Facility | None | $549.54 | $977.24 | $2,238.72 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,023.29 Median $1,318.26 Typical High $2,454.71 | Professional | None (both parts) | $1,023.29 | $1,318.26 | $2,454.71 |
Molina Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None (both parts) | $1,230.27 | $1,230.27 | $1,230.27 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,148.15 Typical High $2,344.23 | Facility | None | $954.99 | $1,148.15 | $2,344.23 |
United Setting Professional Modifier None (both parts) Typical Low $707.95 Median $912.01 Typical High $1,288.25 | Professional | None (both parts) | $707.95 | $912.01 | $1,288.25 |
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 $407.38 Median $407.38 Typical High $575.44 | Professional | 52 · Reduced service | $407.38 | $407.38 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $229.09 | Professional | 53 · Discontinued | $162.18 | $162.18 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $173.78 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $114.82 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $114.82 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $524.81 Median $549.54 Typical High $1,288.25 | Professional | 26 · Professional part | $524.81 | $549.54 | $1,288.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,949.84 Typical High $4,786.30 | Professional | 50 · Both sides | $1,548.82 | $1,949.84 | $4,786.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $645.65 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $512.86 | $645.65 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $263.03 Typical High $645.65 | Professional | 80 · Assistant surgeon | $204.17 | $263.03 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $181.97 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $144.54 | $181.97 | $446.68 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $181.97 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $181.97 | $446.68 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $181.97 Typical High $446.68 | Professional | AS · PA/NP assist | $144.54 | $181.97 | $446.68 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $776.25 Median $812.83 Typical High $1,949.84 | Professional | TC · Technical part | $776.25 | $812.83 | $1,949.84 |
Where South Carolina sits
The same service costs 2.5 times more in Hawaii than in Rhode Island. 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· 39th of 51
$1,072
HI $2,570RI $1,023
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.