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 $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,290.87 Median $2,290.87 Typical High $2,344.23 | Professional | None (both parts) | $2,290.87 | $2,290.87 | $2,344.23 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $2,951.21 Median $2,951.21 Typical High $3,162.28 | Professional | None (both parts) | $2,951.21 | $2,951.21 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $5,495.41 Median $6,025.60 Typical High $18,197.01 | Facility | None | $5,495.41 | $6,025.60 | $18,197.01 |
Medcost Setting Facility Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $8,317.64 | Facility | None | $2,290.87 | $2,754.23 | $8,317.64 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,951.21 Median $2,951.21 Typical High $3,801.89 | Professional | None (both parts) | $2,951.21 | $2,951.21 | $3,801.89 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,467.37 | Facility | None | $2,630.27 | $2,630.27 | $3,467.37 |
United Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $1,737.80 Typical High $2,951.21 | Professional | None (both parts) | $1,230.27 | $1,737.80 | $2,951.21 |
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 $1,148.15 Median $1,148.15 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $467.74 | Professional | 53 · Discontinued | $457.09 | $457.09 | $467.74 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,174.90 Median $1,174.90 Typical High $1,698.24 | Professional | 26 · Professional part | $1,174.90 | $1,174.90 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $4,365.16 Median $4,365.16 Typical High $6,309.57 | Professional | 50 · Both sides | $4,365.16 | $4,365.16 | $6,309.57 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,445.44 Median $1,445.44 Typical High $2,137.96 | Professional | 51 · Multiple procedures | $1,445.44 | $1,445.44 | $2,137.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $588.84 Median $588.84 Typical High $851.14 | Professional | 80 · Assistant surgeon | $588.84 | $588.84 | $851.14 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $407.38 Median $407.38 Typical High $588.84 | Professional | 81 · Minimal assistant surgeon | $407.38 | $407.38 | $588.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $407.38 Median $407.38 Typical High $588.84 | Professional | 82 · Assistant surgeon, no resident | $407.38 | $407.38 | $588.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $407.38 Median $407.38 Typical High $588.84 | Professional | AS · PA/NP assist | $407.38 | $407.38 | $588.84 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $2,691.53 Median $2,691.53 Typical High $3,890.45 | Professional | TC · Technical part | $2,691.53 | $2,691.53 | $3,890.45 |
Where South Carolina sits
The same service costs 37.2 times more in Texas than in Ohio. 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· 20th of 51
$2,951
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.