How much rates vary
Facilitymedian $1,318 · 10th to 90th $1,023 to $2,138Professionalmedian $1,202 · 10th to 90th $955 to $2,138
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 $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,023.29 Median $1,023.29 Typical High $1,288.25 | Professional | None (both parts) | $1,023.29 | $1,023.29 | $1,288.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,137.96 | Facility | None | $1,905.46 | $2,137.96 | $2,137.96 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,202.26 Median $1,737.80 Typical High $2,137.96 | Professional | None (both parts) | $1,202.26 | $1,737.80 | $2,137.96 |
Cigna 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 |
Cigna Setting Professional Modifier None (both parts) Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | None (both parts) | $954.99 | $954.99 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,096.48 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $1,174.90 Typical High $2,570.40 | Facility | None | $676.08 | $1,174.90 | $2,570.40 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,174.90 Median $1,513.56 Typical High $2,754.23 | Professional | None (both parts) | $1,174.90 | $1,513.56 | $2,754.23 |
Molina Setting Professional Modifier None (both parts) Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None (both parts) | $1,412.54 | $1,412.54 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $2,818.38 | Facility | None | $1,122.02 | $1,258.93 | $2,818.38 |
United Setting Professional Modifier None (both parts) Typical Low $794.33 Median $1,047.13 Typical High $1,318.26 | Professional | None (both parts) | $794.33 | $1,047.13 | $1,318.26 |
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 $512.86 Median $512.86 Typical High $630.96 | Professional | 52 · Reduced service | $512.86 | $512.86 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | 53 · Discontinued | $208.93 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $186.21 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $125.89 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $125.89 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $602.56 Median $630.96 Typical High $1,479.11 | Professional | 26 · Professional part | $602.56 | $630.96 | $1,479.11 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,238.72 Typical High $5,495.41 | Professional | 50 · Both sides | $1,778.28 | $2,238.72 | $5,495.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $741.31 Typical High $1,862.09 | Professional | 51 · Multiple procedures | $588.84 | $741.31 | $1,862.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $302.00 Typical High $741.31 | Professional | 80 · Assistant surgeon | $234.42 | $302.00 | $741.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $208.93 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $165.96 | $208.93 | $512.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $208.93 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $208.93 | $512.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $208.93 Typical High $512.86 | Professional | AS · PA/NP assist | $165.96 | $208.93 | $512.86 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $891.25 Median $933.25 Typical High $2,238.72 | Professional | TC · Technical part | $891.25 | $933.25 | $2,238.72 |
Where South Carolina sits
The same service costs 2.9 times more in Hawaii than in Delaware. 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· 42nd of 51
$1,202
HI $2,754DE $955
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.