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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,380.38 Median $1,380.38 Typical High $1,412.54 | Professional | None (both parts) | $1,380.38 | $1,380.38 | $1,412.54 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,737.80 Median $1,737.80 Typical High $1,905.46 | Professional | None (both parts) | $1,737.80 | $1,737.80 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,630.78 Typical High $10,715.19 | Facility | None | $3,311.31 | $3,630.78 | $10,715.19 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $5,011.87 | Facility | None | $1,380.38 | $1,659.59 | $5,011.87 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,737.80 Median $1,737.80 Typical High $2,290.87 | Professional | None (both parts) | $1,737.80 | $1,737.80 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,089.30 | Facility | None | $1,584.89 | $1,584.89 | $2,089.30 |
United Setting Professional Modifier None (both parts) Typical Low $741.31 Median $1,047.13 Typical High $1,737.80 | Professional | None (both parts) | $741.31 | $1,047.13 | $1,737.80 |
10 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 $691.83 Median $691.83 Typical High $707.95 | Professional | 52 · Reduced service | $691.83 | $691.83 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $281.84 | Professional | 53 · Discontinued | $275.42 | $275.42 | $281.84 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $707.95 Median $707.95 Typical High $1,023.29 | Professional | 26 · Professional part | $707.95 | $707.95 | $1,023.29 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,630.27 Median $2,630.27 Typical High $3,801.89 | Professional | 50 · Both sides | $2,630.27 | $2,630.27 | $3,801.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $870.96 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $870.96 | $870.96 | $1,258.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $354.81 Typical High $512.86 | Professional | 80 · Assistant surgeon | $354.81 | $354.81 | $512.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $245.47 Median $245.47 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $245.47 | $245.47 | $354.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $245.47 Median $245.47 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $245.47 | $245.47 | $354.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $245.47 Typical High $354.81 | Professional | AS · PA/NP assist | $245.47 | $245.47 | $354.81 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,584.89 Median $1,584.89 Typical High $2,344.23 | Professional | TC · Technical part | $1,584.89 | $1,584.89 | $2,344.23 |
Where South Carolina sits
The same service costs 138.0 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· 17th of 51
$1,738
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.