How much rates vary
Facilitymedian $1,175 · 10th to 90th $977 to $1,995Professionalmedian $1,122 · 10th to 90th $871 to $1,995
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 $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier None (both parts) Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | None (both parts) | $977.24 | $977.24 | $1,174.90 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $1,548.82 Median $1,548.82 Typical High $1,995.26 | Professional | None (both parts) | $1,548.82 | $1,548.82 | $1,995.26 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,778.28 | $1,995.26 | $1,995.26 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,621.81 Typical High $1,995.26 | Professional | None (both parts) | $1,122.02 | $1,621.81 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Professional Modifier None (both parts) Typical Low $870.96 Median $870.96 Typical High $1,174.90 | Professional | None (both parts) | $870.96 | $870.96 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,071.52 | Professional | None | $1,023.29 | $1,023.29 | $1,071.52 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $1,148.15 Typical High $2,398.83 | Facility | None | $562.34 | $1,148.15 | $2,398.83 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,096.48 Median $1,412.54 Typical High $2,630.27 | Professional | None (both parts) | $1,096.48 | $1,412.54 | $2,630.27 |
Molina Setting Professional Modifier None (both parts) Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None (both parts) | $1,318.26 | $1,318.26 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $2,398.83 | Facility | None | $1,174.90 | $1,479.11 | $2,398.83 |
United Setting Professional Modifier None (both parts) Typical Low $676.08 Median $977.24 Typical High $1,174.90 | Professional | None (both parts) | $676.08 | $977.24 | $1,174.90 |
12 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 $489.78 Median $489.78 Typical High $588.84 | Professional | 52 · Reduced service | $489.78 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $234.42 | Professional | 53 · Discontinued | $194.98 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $177.83 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $117.49 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $117.49 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $562.34 Median $588.84 Typical High $1,380.38 | Professional | 26 · Professional part | $562.34 | $588.84 | $1,380.38 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $2,187.76 Typical High $5,248.07 | Professional | 50 · Both sides | $1,659.59 | $2,187.76 | $5,248.07 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $724.44 Typical High $1,737.80 | Professional | 51 · Multiple procedures | $549.54 | $724.44 | $1,737.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $288.40 Typical High $691.83 | Professional | 80 · Assistant surgeon | $218.78 | $288.40 | $691.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $204.17 Typical High $489.78 | Professional | 81 · Minimal assistant surgeon | $154.88 | $204.17 | $489.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $204.17 Typical High $489.78 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $204.17 | $489.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $204.17 Typical High $489.78 | Professional | AS · PA/NP assist | $154.88 | $204.17 | $489.78 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $851.14 Median $891.25 Typical High $2,089.30 | Professional | TC · Technical part | $851.14 | $891.25 | $2,089.30 |
Where South Carolina sits
The same service costs 4.0 times more in Hawaii than in Pennsylvania. 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· 38th of 51
$1,122
HI $3,467PA $871
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.