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 $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier None (both parts) Typical Low $616.60 Median $616.60 Typical High $630.96 | Professional | None (both parts) | $616.60 | $616.60 | $630.96 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $794.33 Median $794.33 Typical High $851.14 | Professional | None (both parts) | $794.33 | $794.33 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $4,897.79 | Facility | None | $1,513.56 | $1,659.59 | $4,897.79 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $741.31 Typical High $2,290.87 | Facility | None | $616.60 | $741.31 | $2,290.87 |
Medcost Setting Professional Modifier None (both parts) Typical Low $794.33 Median $794.33 Typical High $1,023.29 | Professional | None (both parts) | $794.33 | $794.33 | $1,023.29 |
United Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $954.99 | Facility | None | $707.95 | $707.95 | $954.99 |
United Setting Professional Modifier None (both parts) Typical Low $331.13 Median $478.63 Typical High $794.33 | Professional | None (both parts) | $331.13 | $478.63 | $794.33 |
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 $309.03 Median $309.03 Typical High $316.23 | Professional | 52 · Reduced service | $309.03 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $125.89 | Professional | 53 · Discontinued | $123.03 | $123.03 | $125.89 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $316.23 Median $316.23 Typical High $457.09 | Professional | 26 · Professional part | $316.23 | $316.23 | $457.09 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,202.26 Typical High $1,737.80 | Professional | 50 · Both sides | $1,202.26 | $1,202.26 | $1,737.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $398.11 Median $398.11 Typical High $575.44 | Professional | 51 · Multiple procedures | $398.11 | $398.11 | $575.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $158.49 Typical High $229.09 | Professional | 80 · Assistant surgeon | $158.49 | $158.49 | $229.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $112.20 Median $112.20 Typical High $162.18 | Professional | 81 · Minimal assistant surgeon | $112.20 | $112.20 | $162.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $112.20 Median $112.20 Typical High $162.18 | Professional | 82 · Assistant surgeon, no resident | $112.20 | $112.20 | $162.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $112.20 Typical High $162.18 | Professional | AS · PA/NP assist | $112.20 | $112.20 | $162.18 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $724.44 Median $724.44 Typical High $1,071.52 | Professional | TC · Technical part | $724.44 | $724.44 | $1,071.52 |
Where South Carolina sits
The same service costs 12.0 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· 19th of 51
$794
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.