How much rates vary
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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None (both parts) Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | None (both parts) | $478.63 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 26 · Professional part | $478.63 | $478.63 | $478.63 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $602.56 Median $602.56 Typical High $660.69 | Professional | None (both parts) | $602.56 | $602.56 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $3,715.35 | Facility | None | $1,148.15 | $1,258.93 | $3,715.35 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $575.44 Typical High $1,737.80 | Facility | None | $478.63 | $575.44 | $1,737.80 |
Medcost Setting Professional Modifier None (both parts) Typical Low $602.56 Median $602.56 Typical High $851.14 | Professional | None (both parts) | $602.56 | $602.56 | $851.14 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $245.47 Median $245.47 Typical High $426.58 | Professional | 26 · Professional part | $245.47 | $245.47 | $426.58 |
United Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $724.44 | Facility | None | $549.54 | $549.54 | $724.44 |
United Setting Professional Modifier None (both parts) Typical Low $257.04 Median $363.08 Typical High $602.56 | Professional | None (both parts) | $257.04 | $363.08 | $602.56 |
9 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 $239.88 Median $239.88 Typical High $245.47 | Professional | 52 · Reduced service | $239.88 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $97.72 | Professional | 53 · Discontinued | $95.50 | $95.50 | $97.72 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $912.01 Typical High $1,445.44 | Professional | 50 · Both sides | $912.01 | $912.01 | $1,445.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $302.00 Typical High $489.78 | Professional | 51 · Multiple procedures | $302.00 | $302.00 | $489.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $123.03 Typical High $194.98 | Professional | 80 · Assistant surgeon | $123.03 | $123.03 | $194.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $85.11 Median $85.11 Typical High $134.90 | Professional | 81 · Minimal assistant surgeon | $85.11 | $85.11 | $134.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $85.11 Median $85.11 Typical High $134.90 | Professional | 82 · Assistant surgeon, no resident | $85.11 | $85.11 | $134.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $85.11 Typical High $134.90 | Professional | AS · PA/NP assist | $85.11 | $85.11 | $134.90 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $549.54 Median $549.54 Typical High $977.24 | Professional | TC · Technical part | $549.54 | $549.54 | $977.24 |
Where South Carolina sits
The same service costs 47.9 times more in Texas than in Alabama. 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· 18th of 51
$603
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.