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 $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier None (both parts) Typical Low $3,890.45 Median $3,890.45 Typical High $3,981.07 | Professional | None (both parts) | $3,890.45 | $3,890.45 | $3,981.07 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $5,011.87 Median $5,011.87 Typical High $5,370.32 | Professional | None (both parts) | $5,011.87 | $5,011.87 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $9,549.93 Median $10,471.29 Typical High $30,902.95 | Facility | None | $9,549.93 | $10,471.29 | $30,902.95 |
Medcost Setting Facility Modifier None Typical Low $3,890.45 Median $4,677.35 Typical High $14,454.40 | Facility | None | $3,890.45 | $4,677.35 | $14,454.40 |
Medcost Setting Professional Modifier None (both parts) Typical Low $5,011.87 Median $5,011.87 Typical High $6,456.54 | Professional | None (both parts) | $5,011.87 | $5,011.87 | $6,456.54 |
United Setting Professional Modifier None (both parts) Typical Low $2,089.30 Median $3,019.95 Typical High $5,011.87 | Professional | None (both parts) | $2,089.30 | $3,019.95 | $5,011.87 |
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 $1,949.84 Median $1,949.84 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,949.84 | $1,949.84 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $776.25 Typical High $794.33 | Professional | 53 · Discontinued | $776.25 | $776.25 | $794.33 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,995.26 Median $1,995.26 Typical High $2,884.03 | Professional | 26 · Professional part | $1,995.26 | $1,995.26 | $2,884.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $7,585.78 Median $7,585.78 Typical High $10,964.78 | Professional | 50 · Both sides | $7,585.78 | $7,585.78 | $10,964.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2,511.89 Median $2,511.89 Typical High $3,630.78 | Professional | 51 · Multiple procedures | $2,511.89 | $2,511.89 | $3,630.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,000.00 Median $1,000.00 Typical High $1,445.44 | Professional | 80 · Assistant surgeon | $1,000.00 | $1,000.00 | $1,445.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $707.95 Median $707.95 Typical High $1,023.29 | Professional | 81 · Minimal assistant surgeon | $707.95 | $707.95 | $1,023.29 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $707.95 Median $707.95 Typical High $1,023.29 | Professional | 82 · Assistant surgeon, no resident | $707.95 | $707.95 | $1,023.29 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $707.95 Median $707.95 Typical High $1,023.29 | Professional | AS · PA/NP assist | $707.95 | $707.95 | $1,023.29 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $4,570.88 Median $4,570.88 Typical High $6,760.83 | Professional | TC · Technical part | $4,570.88 | $4,570.88 | $6,760.83 |
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· 18th of 51
$5,012
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.