How much rates vary
Facilitymedian $724 · 10th to 90th $537 to $1,318Professionalmedian $646 · 10th to 90th $513 to $1,096
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 $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None (both parts) | $537.03 | $537.03 | $741.31 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None (both parts) | $1,096.48 | $1,096.48 | $1,096.48 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,000.00 | $1,096.48 | $1,096.48 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $645.65 Median $933.25 Typical High $1,096.48 | Professional | None (both parts) | $645.65 | $933.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $851.14 | Facility | None | $724.44 | $724.44 | $851.14 |
Cigna Setting Professional Modifier None (both parts) Typical Low $537.03 Median $537.03 Typical High $851.14 | Professional | None (both parts) | $537.03 | $537.03 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $602.56 Typical High $1,318.26 | Facility | None | $309.03 | $602.56 | $1,318.26 |
Medcost Setting Professional Modifier None (both parts) Typical Low $758.58 Median $758.58 Typical High $1,445.44 | Professional | None (both parts) | $758.58 | $758.58 | $1,445.44 |
Molina Setting Professional Modifier None (both parts) Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None (both parts) | $724.44 | $724.44 | $724.44 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
United Setting Professional Modifier None (both parts) Typical Low $371.54 Median $524.81 Typical High $645.65 | Professional | None (both parts) | $371.54 | $524.81 | $645.65 |
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 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $97.72 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $64.57 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $302.00 Median $323.59 Typical High $758.58 | Professional | 26 · Professional part | $302.00 | $323.59 | $758.58 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,202.26 Typical High $2,884.03 | Professional | 50 · Both sides | $1,148.15 | $1,202.26 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $398.11 Typical High $954.99 | Professional | 51 · Multiple procedures | $380.19 | $398.11 | $954.99 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $162.18 Typical High $380.19 | Professional | 80 · Assistant surgeon | $151.36 | $162.18 | $380.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $112.20 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $107.15 | $112.20 | $269.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $112.20 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $112.20 | $269.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $112.20 Typical High $269.15 | Professional | AS · PA/NP assist | $107.15 | $112.20 | $269.15 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $457.09 Median $489.78 Typical High $1,148.15 | Professional | TC · Technical part | $457.09 | $489.78 | $1,148.15 |
Where South Carolina sits
The same service costs 2.0 times more in Montana than in West Virginia. 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· 29th of 51
$646
MT $1,096WV $537
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.