How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,950 to $4,467Professionalmedian $2,512 · 10th to 90th $1,950 to $4,467
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 $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,949.84 Median $1,949.84 Typical High $2,754.23 | Professional | None (both parts) | $1,949.84 | $1,949.84 | $2,754.23 |
BCBS South Carolina Setting Facility Modifier None Typical Low $4,073.80 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,073.80 | $4,466.84 | $4,466.84 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $2,511.89 Median $3,630.78 Typical High $4,466.84 | Professional | None (both parts) | $2,511.89 | $3,630.78 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,995.26 Median $1,995.26 Typical High $2,754.23 | Professional | None (both parts) | $1,995.26 | $1,995.26 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,398.83 | Professional | None | $2,290.87 | $2,290.87 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $1,288.25 Median $2,137.96 Typical High $5,370.32 | Facility | None | $1,288.25 | $2,137.96 | $5,370.32 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,454.71 Median $3,162.28 Typical High $5,888.44 | Professional | None (both parts) | $2,454.71 | $3,162.28 | $5,888.44 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $5,370.32 | Facility | None | $2,187.76 | $2,398.83 | $5,370.32 |
United Setting Professional Modifier None (both parts) Typical Low $1,659.59 Median $2,187.76 Typical High $2,951.21 | Professional | None (both parts) | $1,659.59 | $2,187.76 | $2,951.21 |
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 $977.24 Median $977.24 Typical High $1,380.38 | Professional | 52 · Reduced service | $977.24 | $977.24 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $562.34 | Professional | 53 · Discontinued | $389.05 | $389.05 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $416.87 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $275.42 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $275.42 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,258.93 Median $1,318.26 Typical High $3,090.30 | Professional | 26 · Professional part | $1,258.93 | $1,318.26 | $3,090.30 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,715.35 Median $4,677.35 Typical High $11,748.98 | Professional | 50 · Both sides | $3,715.35 | $4,677.35 | $11,748.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,230.27 Median $1,584.89 Typical High $3,890.45 | Professional | 51 · Multiple procedures | $1,230.27 | $1,584.89 | $3,890.45 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $489.78 Median $630.96 Typical High $1,548.82 | Professional | 80 · Assistant surgeon | $489.78 | $630.96 | $1,548.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $346.74 Median $436.52 Typical High $1,096.48 | Professional | 81 · Minimal assistant surgeon | $346.74 | $436.52 | $1,096.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $346.74 Median $436.52 Typical High $1,096.48 | Professional | 82 · Assistant surgeon, no resident | $346.74 | $436.52 | $1,096.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $436.52 Typical High $1,096.48 | Professional | AS · PA/NP assist | $346.74 | $436.52 | $1,096.48 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,905.46 Median $1,995.26 Typical High $4,677.35 | Professional | TC · Technical part | $1,905.46 | $1,995.26 | $4,677.35 |
Where South Carolina sits
The same service costs 2.6 times more in Hawaii 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· 30th of 51
$2,512
HI $5,129WV $1,995
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.