How much rates vary
Facilitymedian $1,585 · 10th to 90th $891 to $2,042Professionalmedian $1,148 · 10th to 90th $891 to $2,042
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 $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier None (both parts) Typical Low $891.25 Median $891.25 Typical High $1,258.93 | Professional | None (both parts) | $891.25 | $891.25 | $1,258.93 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,041.74 | Facility | None | $1,819.70 | $2,041.74 | $2,041.74 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,148.15 Median $1,659.59 Typical High $2,041.74 | Professional | None (both parts) | $1,148.15 | $1,659.59 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,148.15 Median $1,148.15 Typical High $1,584.89 | Professional | None (both parts) | $1,148.15 | $1,148.15 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,000.00 Typical High $2,454.71 | Facility | None | $588.84 | $1,000.00 | $2,454.71 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,445.44 Typical High $2,691.53 | Professional | None (both parts) | $1,122.02 | $1,445.44 | $2,691.53 |
Molina Setting Professional Modifier None (both parts) Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None (both parts) | $1,348.96 | $1,348.96 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $2,454.71 | Facility | None | $1,202.26 | $1,258.93 | $2,454.71 |
United Setting Professional Modifier None (both parts) Typical Low $758.58 Median $1,000.00 Typical High $1,380.38 | Professional | None (both parts) | $758.58 | $1,000.00 | $1,380.38 |
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 $446.68 Median $446.68 Typical High $630.96 | Professional | 52 · Reduced service | $446.68 | $446.68 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $251.19 | Professional | 53 · Discontinued | $177.83 | $177.83 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $190.55 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $125.89 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $125.89 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $575.44 Median $602.56 Typical High $1,412.54 | Professional | 26 · Professional part | $575.44 | $602.56 | $1,412.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,137.96 Typical High $5,370.32 | Professional | 50 · Both sides | $1,698.24 | $2,137.96 | $5,370.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $724.44 Typical High $1,778.28 | Professional | 51 · Multiple procedures | $562.34 | $724.44 | $1,778.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $288.40 Typical High $707.95 | Professional | 80 · Assistant surgeon | $223.87 | $288.40 | $707.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $199.53 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $158.49 | $199.53 | $501.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $199.53 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $199.53 | $501.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $199.53 Typical High $501.19 | Professional | AS · PA/NP assist | $158.49 | $199.53 | $501.19 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $870.96 Median $912.01 Typical High $2,137.96 | Professional | TC · Technical part | $870.96 | $912.01 | $2,137.96 |
Where South Carolina sits
The same service costs 2.8 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· 37th of 51
$1,148
HI $2,692DC $977
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.