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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,659.59 Median $1,659.59 Typical High $1,698.24 | Professional | None (both parts) | $1,659.59 | $1,659.59 | $1,698.24 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 26 · Professional part | $1,659.59 | $1,659.59 | $1,659.59 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $2,137.96 Median $2,137.96 Typical High $2,290.87 | Professional | None (both parts) | $2,137.96 | $2,137.96 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $3,981.07 Median $4,466.84 Typical High $13,182.57 | Facility | None | $3,981.07 | $4,466.84 | $13,182.57 |
Medcost Setting Facility Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $6,165.95 | Facility | None | $1,659.59 | $1,995.26 | $6,165.95 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,137.96 Median $2,137.96 Typical High $2,951.21 | Professional | None (both parts) | $2,137.96 | $2,137.96 | $2,951.21 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $851.14 Median $851.14 Typical High $1,479.11 | Professional | 26 · Professional part | $851.14 | $851.14 | $1,479.11 |
United Setting Professional Modifier None (both parts) Typical Low $891.25 Median $1,288.25 Typical High $2,137.96 | Professional | None (both parts) | $891.25 | $1,288.25 | $2,137.96 |
9 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 $831.76 Median $831.76 Typical High $851.14 | Professional | 52 · Reduced service | $831.76 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $338.84 | Professional | 53 · Discontinued | $331.13 | $331.13 | $338.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,162.28 Median $3,162.28 Typical High $5,128.61 | Professional | 50 · Both sides | $3,162.28 | $3,162.28 | $5,128.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,071.52 Median $1,071.52 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $1,071.52 | $1,071.52 | $1,698.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $426.58 Typical High $676.08 | Professional | 80 · Assistant surgeon | $426.58 | $426.58 | $676.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $295.12 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $295.12 | $295.12 | $478.63 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $295.12 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $295.12 | $478.63 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $295.12 Typical High $478.63 | Professional | AS · PA/NP assist | $295.12 | $295.12 | $478.63 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,949.84 Median $1,949.84 Typical High $3,388.44 | Professional | TC · Technical part | $1,949.84 | $1,949.84 | $3,388.44 |
Where South Carolina sits
The same service costs 229.1 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· 12th of 51
$2,138
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.