How much rates vary
Facilitymedian $646 · 10th to 90th $407 to $933Professionalmedian $537 · 10th to 90th $407 to $933
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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None (both parts) Typical Low $407.38 Median $407.38 Typical High $562.34 | Professional | None (both parts) | $407.38 | $407.38 | $562.34 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $933.25 Typical High $933.25 | Facility | None | $851.14 | $933.25 | $933.25 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $537.03 Median $776.25 Typical High $933.25 | Professional | None (both parts) | $537.03 | $776.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Professional Modifier None (both parts) Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | None (both parts) | $467.74 | $467.74 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | None | $380.19 | $380.19 | $446.68 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $457.09 Typical High $1,122.02 | Facility | None | $239.88 | $457.09 | $1,122.02 |
Medcost Setting Professional Modifier None (both parts) Typical Low $512.86 Median $660.69 Typical High $1,230.27 | Professional | None (both parts) | $512.86 | $660.69 | $1,230.27 |
Molina Setting Professional Modifier None (both parts) Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None (both parts) | $616.60 | $616.60 | $616.60 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,023.29 Typical High $1,023.29 | Facility | None | $489.78 | $1,023.29 | $1,023.29 |
United Setting Professional Modifier None (both parts) Typical Low $309.03 Median $457.09 Typical High $575.44 | Professional | None (both parts) | $309.03 | $457.09 | $575.44 |
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 $204.17 Median $204.17 Typical High $281.84 | Professional | 52 · Reduced service | $204.17 | $204.17 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $112.20 | Professional | 53 · Discontinued | $81.28 | $81.28 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $85.11 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $56.23 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $263.03 Median $275.42 Typical High $645.65 | Professional | 26 · Professional part | $263.03 | $275.42 | $645.65 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $977.24 Typical High $2,454.71 | Professional | 50 · Both sides | $776.25 | $977.24 | $2,454.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $331.13 Typical High $812.83 | Professional | 51 · Multiple procedures | $257.04 | $331.13 | $812.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $131.83 Typical High $323.59 | Professional | 80 · Assistant surgeon | $102.33 | $131.83 | $323.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $72.44 Median $93.33 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $72.44 | $93.33 | $229.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $72.44 Median $93.33 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $72.44 | $93.33 | $229.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $93.33 Typical High $229.09 | Professional | AS · PA/NP assist | $72.44 | $93.33 | $229.09 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $398.11 Median $416.87 Typical High $977.24 | Professional | TC · Technical part | $398.11 | $416.87 | $977.24 |
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· 25th of 51
$537
HI $1,096DC $407
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.