How much rates vary
Facilitymedian $3,020 · 10th to 90th $2,138 to $4,786Professionalmedian $2,692 · 10th to 90th $2,138 to $4,786
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 $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,137.96 Median $2,137.96 Typical High $3,019.95 | Professional | None (both parts) | $2,137.96 | $2,137.96 | $3,019.95 |
BCBS South Carolina Setting Facility Modifier None Typical Low $4,365.16 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,365.16 | $4,786.30 | $4,786.30 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $2,511.89 Median $4,365.16 Typical High $4,786.30 | Professional | None (both parts) | $2,511.89 | $4,365.16 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Cigna Setting Professional Modifier None (both parts) Typical Low $2,187.76 Median $2,187.76 Typical High $3,019.95 | Professional | None (both parts) | $2,187.76 | $2,187.76 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $2,137.96 Median $2,884.03 Typical High $5,888.44 | Facility | None | $2,137.96 | $2,884.03 | $5,888.44 |
Medcost Setting Professional Modifier None (both parts) Typical Low $3,630.78 Median $3,630.78 Typical High $6,309.57 | Professional | None (both parts) | $3,630.78 | $3,630.78 | $6,309.57 |
United Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Facility | None | $5,370.32 | $5,370.32 | $5,370.32 |
United Setting Professional Modifier None (both parts) Typical Low $1,659.59 Median $2,344.23 Typical High $3,090.30 | Professional | None (both parts) | $1,659.59 | $2,344.23 | $3,090.30 |
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 $1,047.13 Median $1,047.13 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $602.56 | Professional | 53 · Discontinued | $426.58 | $426.58 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $446.68 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $302.00 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $302.00 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,479.11 Median $1,479.11 Typical High $3,311.31 | Professional | 26 · Professional part | $1,479.11 | $1,479.11 | $3,311.31 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $5,495.41 Median $5,495.41 Typical High $12,589.25 | Professional | 50 · Both sides | $5,495.41 | $5,495.41 | $12,589.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,819.70 Median $1,819.70 Typical High $4,168.69 | Professional | 51 · Multiple procedures | $1,819.70 | $1,819.70 | $4,168.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $724.44 Median $724.44 Typical High $1,659.59 | Professional | 80 · Assistant surgeon | $724.44 | $724.44 | $1,659.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $512.86 Median $512.86 Typical High $1,174.90 | Professional | 81 · Minimal assistant surgeon | $512.86 | $512.86 | $1,174.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $512.86 Median $512.86 Typical High $1,174.90 | Professional | 82 · Assistant surgeon, no resident | $512.86 | $512.86 | $1,174.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $512.86 Median $512.86 Typical High $1,174.90 | Professional | AS · PA/NP assist | $512.86 | $512.86 | $1,174.90 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $2,187.76 Median $2,187.76 Typical High $5,011.87 | Professional | TC · Technical part | $2,187.76 | $2,187.76 | $5,011.87 |
Where South Carolina sits
The same service costs 2.4 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· 33rd of 51
$2,754
HI $5,248WV $2,188
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.