How much rates vary
Facilitymedian $4,898 · 10th to 90th $2,754 to $6,310Professionalmedian $3,631 · 10th to 90th $2,754 to $6,310
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 $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,754.23 Median $2,754.23 Typical High $3,890.45 | Professional | None (both parts) | $2,754.23 | $2,754.23 | $3,890.45 |
BCBS South Carolina Setting Facility Modifier None Typical Low $5,754.40 Median $6,309.57 Typical High $6,309.57 | Facility | None | $5,754.40 | $6,309.57 | $6,309.57 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $3,630.78 Median $5,128.61 Typical High $6,309.57 | Professional | None (both parts) | $3,630.78 | $5,128.61 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
Cigna Setting Professional Modifier None (both parts) Typical Low $3,548.13 Median $3,548.13 Typical High $4,897.79 | Professional | None (both parts) | $3,548.13 | $3,548.13 | $4,897.79 |
Medcost Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,715.35 | Professional | None | $3,235.94 | $3,235.94 | $3,715.35 |
Medcost Setting Facility Modifier None Typical Low $1,995.26 Median $3,311.31 Typical High $7,585.78 | Facility | None | $1,995.26 | $3,311.31 | $7,585.78 |
Medcost Setting Professional Modifier None (both parts) Typical Low $3,467.37 Median $4,466.84 Typical High $8,317.64 | Professional | None (both parts) | $3,467.37 | $4,466.84 | $8,317.64 |
United Setting Facility Modifier None Typical Low $4,073.80 Median $5,370.32 Typical High $8,317.64 | Facility | None | $4,073.80 | $5,370.32 | $8,317.64 |
United Setting Professional Modifier None (both parts) Typical Low $2,398.83 Median $3,090.30 Typical High $4,677.35 | Professional | None (both parts) | $2,398.83 | $3,090.30 | $4,677.35 |
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 $1,380.38 Median $1,380.38 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $776.25 | Professional | 53 · Discontinued | $549.54 | $549.54 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $588.84 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $389.05 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $389.05 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,778.28 Median $1,862.09 Typical High $4,365.16 | Professional | 26 · Professional part | $1,778.28 | $1,862.09 | $4,365.16 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $5,248.07 Median $6,606.93 Typical High $16,595.87 | Professional | 50 · Both sides | $5,248.07 | $6,606.93 | $16,595.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,737.80 Median $2,238.72 Typical High $5,495.41 | Professional | 51 · Multiple procedures | $1,737.80 | $2,238.72 | $5,495.41 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $691.83 Median $891.25 Typical High $2,187.76 | Professional | 80 · Assistant surgeon | $691.83 | $891.25 | $2,187.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $489.78 Median $616.60 Typical High $1,548.82 | Professional | 81 · Minimal assistant surgeon | $489.78 | $616.60 | $1,548.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $489.78 Median $616.60 Typical High $1,548.82 | Professional | 82 · Assistant surgeon, no resident | $489.78 | $616.60 | $1,548.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $489.78 Median $616.60 Typical High $1,548.82 | Professional | AS · PA/NP assist | $489.78 | $616.60 | $1,548.82 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $2,691.53 Median $2,818.38 Typical High $6,606.93 | Professional | TC · Technical part | $2,691.53 | $2,818.38 | $6,606.93 |
Where South Carolina sits
The same service costs 3.5 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· 39th of 51
$3,631
HI $11,482DC $3,311
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.