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 $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier None (both parts) Typical Low $3,235.94 Median $3,235.94 Typical High $3,311.31 | Professional | None (both parts) | $3,235.94 | $3,235.94 | $3,311.31 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $4,168.69 Median $4,168.69 Typical High $4,570.88 | Professional | None (both parts) | $4,168.69 | $4,168.69 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $7,943.28 Median $8,709.64 Typical High $25,703.96 | Facility | None | $7,943.28 | $8,709.64 | $25,703.96 |
Medcost Setting Facility Modifier None Typical Low $3,235.94 Median $3,890.45 Typical High $12,022.64 | Facility | None | $3,235.94 | $3,890.45 | $12,022.64 |
Medcost Setting Professional Modifier None (both parts) Typical Low $4,168.69 Median $4,168.69 Typical High $5,495.41 | Professional | None (both parts) | $4,168.69 | $4,168.69 | $5,495.41 |
United Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $5,011.87 | Facility | None | $3,801.89 | $3,801.89 | $5,011.87 |
United Setting Professional Modifier None (both parts) Typical Low $1,737.80 Median $2,511.89 Typical High $4,168.69 | Professional | None (both parts) | $1,737.80 | $2,511.89 | $4,168.69 |
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 $1,621.81 Median $1,621.81 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,621.81 | $1,621.81 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $645.65 Typical High $676.08 | Professional | 53 · Discontinued | $645.65 | $645.65 | $676.08 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,659.59 Median $1,659.59 Typical High $2,398.83 | Professional | 26 · Professional part | $1,659.59 | $1,659.59 | $2,398.83 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $6,309.57 Median $6,309.57 Typical High $9,120.11 | Professional | 50 · Both sides | $6,309.57 | $6,309.57 | $9,120.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2,089.30 Median $2,089.30 Typical High $3,019.95 | Professional | 51 · Multiple procedures | $2,089.30 | $2,089.30 | $3,019.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $831.76 Median $831.76 Typical High $1,202.26 | Professional | 80 · Assistant surgeon | $831.76 | $831.76 | $1,202.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $588.84 Median $588.84 Typical High $851.14 | Professional | 81 · Minimal assistant surgeon | $588.84 | $588.84 | $851.14 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $588.84 Median $588.84 Typical High $851.14 | Professional | 82 · Assistant surgeon, no resident | $588.84 | $588.84 | $851.14 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $588.84 Median $588.84 Typical High $851.14 | Professional | AS · PA/NP assist | $588.84 | $588.84 | $851.14 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $3,801.89 Median $3,801.89 Typical High $5,623.41 | Professional | TC · Technical part | $3,801.89 | $3,801.89 | $5,623.41 |
Where South Carolina sits
The same service costs 67.6 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· 19th of 51
$4,169
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.