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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None (both parts) Typical Low $204.17 Median $204.17 Typical High $208.93 | Professional | None (both parts) | $204.17 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 26 · Professional part | $204.17 | $204.17 | $204.17 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $263.03 Median $263.03 Typical High $281.84 | Professional | None (both parts) | $263.03 | $263.03 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $537.03 Typical High $1,621.81 | Facility | None | $489.78 | $537.03 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $204.17 Median $245.47 Typical High $758.58 | Facility | None | $204.17 | $245.47 | $758.58 |
Medcost Setting Professional Modifier None (both parts) Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None (both parts) | $263.03 | $263.03 | $363.08 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $104.71 Median $104.71 Typical High $181.97 | Professional | 26 · Professional part | $104.71 | $104.71 | $181.97 |
United Setting Professional Modifier None (both parts) Typical Low $109.65 Median $154.88 Typical High $263.03 | Professional | None (both parts) | $109.65 | $154.88 | $263.03 |
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 $102.33 Median $102.33 Typical High $104.71 | Professional | 52 · Reduced service | $102.33 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $41.69 | Professional | 53 · Discontinued | $40.74 | $40.74 | $41.69 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $389.05 Typical High $630.96 | Professional | 50 · Both sides | $389.05 | $389.05 | $630.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $128.82 Typical High $208.93 | Professional | 51 · Multiple procedures | $128.82 | $128.82 | $208.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $52.48 Typical High $83.18 | Professional | 80 · Assistant surgeon | $52.48 | $52.48 | $83.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $36.31 Median $36.31 Typical High $58.88 | Professional | 81 · Minimal assistant surgeon | $36.31 | $36.31 | $58.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $36.31 Median $36.31 Typical High $58.88 | Professional | 82 · Assistant surgeon, no resident | $36.31 | $36.31 | $58.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $36.31 Typical High $58.88 | Professional | AS · PA/NP assist | $36.31 | $36.31 | $58.88 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $239.88 Median $239.88 Typical High $416.87 | Professional | TC · Technical part | $239.88 | $239.88 | $416.87 |
Where South Carolina sits
The same service costs 5.4 times more in Alaska 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· 17th of 51
$263
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.