How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,479 to $3,388Professionalmedian $1,905 · 10th to 90th $1,479 to $3,388
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 $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,479.11 Median $1,479.11 Typical High $2,089.30 | Professional | None (both parts) | $1,479.11 | $1,479.11 | $2,089.30 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,019.95 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,019.95 | $3,388.44 | $3,388.44 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,905.46 Median $2,754.23 Typical High $3,388.44 | Professional | None (both parts) | $1,905.46 | $2,754.23 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,819.70 Median $1,819.70 Typical High $2,454.71 | Professional | None (both parts) | $1,819.70 | $1,819.70 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,995.26 | $2,137.96 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $4,073.80 | Facility | None | $1,071.52 | $1,659.59 | $4,073.80 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,862.09 Median $2,398.83 Typical High $4,365.16 | Professional | None (both parts) | $1,862.09 | $2,398.83 | $4,365.16 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $2,290.87 Typical High $4,466.84 | Facility | None | $2,187.76 | $2,290.87 | $4,466.84 |
United Setting Professional Modifier None (both parts) Typical Low $1,288.25 Median $1,659.59 Typical High $2,511.89 | Professional | None (both parts) | $1,288.25 | $1,659.59 | $2,511.89 |
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 $741.31 Median $741.31 Typical High $1,047.13 | Professional | 52 · Reduced service | $741.31 | $741.31 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $416.87 | Professional | 53 · Discontinued | $295.12 | $295.12 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $316.23 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $208.93 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $208.93 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $954.99 Median $1,000.00 Typical High $2,344.23 | Professional | 26 · Professional part | $954.99 | $1,000.00 | $2,344.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,818.38 Median $3,548.13 Typical High $8,709.64 | Professional | 50 · Both sides | $2,818.38 | $3,548.13 | $8,709.64 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $933.25 Median $1,174.90 Typical High $2,951.21 | Professional | 51 · Multiple procedures | $933.25 | $1,174.90 | $2,951.21 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $478.63 Typical High $1,174.90 | Professional | 80 · Assistant surgeon | $371.54 | $478.63 | $1,174.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $263.03 Median $331.13 Typical High $812.83 | Professional | 81 · Minimal assistant surgeon | $263.03 | $331.13 | $812.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $263.03 Median $331.13 Typical High $812.83 | Professional | 82 · Assistant surgeon, no resident | $263.03 | $331.13 | $812.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $331.13 Typical High $812.83 | Professional | AS · PA/NP assist | $263.03 | $331.13 | $812.83 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,412.54 Median $1,479.11 Typical High $3,548.13 | Professional | TC · Technical part | $1,412.54 | $1,479.11 | $3,548.13 |
Where South Carolina sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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
$1,905
HI $5,623DC $1,778
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.