How much rates vary
Facilitymedian $1,230 · 10th to 90th $776 to $1,778Professionalmedian $1,000 · 10th to 90th $776 to $1,778
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 $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier None (both parts) Typical Low $776.25 Median $776.25 Typical High $1,096.48 | Professional | None (both parts) | $776.25 | $776.25 | $1,096.48 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,584.89 | $1,778.28 | $1,778.28 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,000.00 Median $1,445.44 Typical High $1,778.28 | Professional | None (both parts) | $1,000.00 | $1,445.44 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Professional Modifier None (both parts) Typical Low $891.25 Median $891.25 Typical High $1,230.27 | Professional | None (both parts) | $891.25 | $891.25 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,047.13 | $1,148.15 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $933.25 Typical High $2,137.96 | Facility | None | $549.54 | $933.25 | $2,137.96 |
Medcost Setting Professional Modifier None (both parts) Typical Low $977.24 Median $1,230.27 Typical High $2,290.87 | Professional | None (both parts) | $977.24 | $1,230.27 | $2,290.87 |
Molina Setting Professional Modifier None (both parts) Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None (both parts) | $1,174.90 | $1,174.90 | $1,174.90 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,148.15 Typical High $2,344.23 | Facility | None | $977.24 | $1,148.15 | $2,344.23 |
United Setting Professional Modifier None (both parts) Typical Low $676.08 Median $870.96 Typical High $1,288.25 | Professional | None (both parts) | $676.08 | $870.96 | $1,288.25 |
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 $389.05 Median $389.05 Typical High $549.54 | Professional | 52 · Reduced service | $389.05 | $389.05 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $218.78 | Professional | 53 · Discontinued | $154.88 | $154.88 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $162.18 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $109.65 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $109.65 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $489.78 Median $524.81 Typical High $1,230.27 | Professional | 26 · Professional part | $489.78 | $524.81 | $1,230.27 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,862.09 Typical High $4,570.88 | Professional | 50 · Both sides | $1,445.44 | $1,862.09 | $4,570.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $616.60 Typical High $1,513.56 | Professional | 51 · Multiple procedures | $489.78 | $616.60 | $1,513.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $245.47 Typical High $616.60 | Professional | 80 · Assistant surgeon | $194.98 | $245.47 | $616.60 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $134.90 Median $173.78 Typical High $426.58 | Professional | 81 · Minimal assistant surgeon | $134.90 | $173.78 | $426.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $134.90 Median $173.78 Typical High $426.58 | Professional | 82 · Assistant surgeon, no resident | $134.90 | $173.78 | $426.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $173.78 Typical High $426.58 | Professional | AS · PA/NP assist | $134.90 | $173.78 | $426.58 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $741.31 Median $776.25 Typical High $1,819.70 | Professional | TC · Technical part | $741.31 | $776.25 | $1,819.70 |
Where South Carolina sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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· 43rd of 51
$1,000
HI $2,455PA $891
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.