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 $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,089.30 Median $2,089.30 Typical High $2,137.96 | Professional | None (both parts) | $2,089.30 | $2,089.30 | $2,137.96 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $2,630.27 Median $2,630.27 Typical High $2,884.03 | Professional | None (both parts) | $2,630.27 | $2,630.27 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $5,011.87 Median $5,495.41 Typical High $16,218.10 | Facility | None | $5,011.87 | $5,495.41 | $16,218.10 |
Medcost Setting Facility Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $7,585.78 | Facility | None | $2,089.30 | $2,454.71 | $7,585.78 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,630.27 Median $2,630.27 Typical High $3,467.37 | Professional | None (both parts) | $2,630.27 | $2,630.27 | $3,467.37 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,162.28 | Facility | None | $2,398.83 | $2,398.83 | $3,162.28 |
United Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,584.89 Typical High $2,630.27 | Professional | None (both parts) | $1,122.02 | $1,584.89 | $2,630.27 |
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 $1,023.29 Median $1,023.29 Typical High $1,071.52 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $426.58 | Professional | 53 · Discontinued | $416.87 | $416.87 | $426.58 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,071.52 Median $1,071.52 Typical High $1,548.82 | Professional | 26 · Professional part | $1,071.52 | $1,071.52 | $1,548.82 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,981.07 Median $3,981.07 Typical High $5,754.40 | Professional | 50 · Both sides | $3,981.07 | $3,981.07 | $5,754.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,318.26 Median $1,318.26 Typical High $1,905.46 | Professional | 51 · Multiple procedures | $1,318.26 | $1,318.26 | $1,905.46 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $524.81 Typical High $776.25 | Professional | 80 · Assistant surgeon | $524.81 | $524.81 | $776.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $371.54 Median $371.54 Typical High $537.03 | Professional | 81 · Minimal assistant surgeon | $371.54 | $371.54 | $537.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $371.54 Median $371.54 Typical High $537.03 | Professional | 82 · Assistant surgeon, no resident | $371.54 | $371.54 | $537.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $371.54 Typical High $537.03 | Professional | AS · PA/NP assist | $371.54 | $371.54 | $537.03 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $2,398.83 Median $2,398.83 Typical High $3,548.13 | Professional | TC · Technical part | $2,398.83 | $2,398.83 | $3,548.13 |
Where South Carolina sits
The same service costs 31.6 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· 15th of 51
$2,630
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.