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 $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,691.53 Median $2,691.53 Typical High $2,754.23 | Professional | None (both parts) | $2,691.53 | $2,691.53 | $2,754.23 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $3,467.37 Median $3,467.37 Typical High $3,715.35 | Professional | None (both parts) | $3,467.37 | $3,467.37 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $6,456.54 Median $7,079.46 Typical High $21,379.62 | Facility | None | $6,456.54 | $7,079.46 | $21,379.62 |
Medcost Setting Facility Modifier None Typical Low $2,691.53 Median $3,235.94 Typical High $10,000.00 | Facility | None | $2,691.53 | $3,235.94 | $10,000.00 |
Medcost Setting Professional Modifier None (both parts) Typical Low $3,467.37 Median $3,467.37 Typical High $4,466.84 | Professional | None (both parts) | $3,467.37 | $3,467.37 | $4,466.84 |
United Setting Professional Modifier None (both parts) Typical Low $1,445.44 Median $2,041.74 Typical High $3,467.37 | Professional | None (both parts) | $1,445.44 | $2,041.74 | $3,467.37 |
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 $1,348.96 Median $1,348.96 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,348.96 | $1,348.96 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $537.03 Typical High $549.54 | Professional | 53 · Discontinued | $537.03 | $537.03 | $549.54 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,380.38 Median $1,380.38 Typical High $1,995.26 | Professional | 26 · Professional part | $1,380.38 | $1,380.38 | $1,995.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $5,128.61 Median $5,128.61 Typical High $7,413.10 | Professional | 50 · Both sides | $5,128.61 | $5,128.61 | $7,413.10 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,737.80 Median $1,737.80 Typical High $2,511.89 | Professional | 51 · Multiple procedures | $1,737.80 | $1,737.80 | $2,511.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $691.83 Median $691.83 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $691.83 | $691.83 | $1,000.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $478.63 Median $478.63 Typical High $691.83 | Professional | 81 · Minimal assistant surgeon | $478.63 | $478.63 | $691.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $478.63 Median $478.63 Typical High $691.83 | Professional | 82 · Assistant surgeon, no resident | $478.63 | $478.63 | $691.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $478.63 Median $478.63 Typical High $691.83 | Professional | AS · PA/NP assist | $478.63 | $478.63 | $691.83 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $3,162.28 Median $3,162.28 Typical High $4,570.88 | Professional | TC · Technical part | $3,162.28 | $3,162.28 | $4,570.88 |
Where South Carolina sits
The same service costs 35.5 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· 16th of 51
$3,467
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.