How much rates vary
Facilitymedian $1,585 · 10th to 90th $977 to $2,239Professionalmedian $1,259 · 10th to 90th $977 to $2,239
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 $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier None (both parts) Typical Low $977.24 Median $977.24 Typical High $1,380.38 | Professional | None (both parts) | $977.24 | $977.24 | $1,380.38 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $2,238.72 | Facility | None | $1,995.26 | $2,238.72 | $2,238.72 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,258.93 Median $1,819.70 Typical High $2,238.72 | Professional | None (both parts) | $1,258.93 | $1,819.70 | $2,238.72 |
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 $1,174.90 Median $1,174.90 Typical High $1,584.89 | Professional | None (both parts) | $1,174.90 | $1,174.90 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,380.38 | Professional | None | $1,288.25 | $1,288.25 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $1,174.90 Typical High $2,691.53 | Facility | None | $691.83 | $1,174.90 | $2,691.53 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $1,548.82 Typical High $2,884.03 | Professional | None (both parts) | $1,230.27 | $1,548.82 | $2,884.03 |
Molina Setting Professional Modifier None (both parts) Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None (both parts) | $1,479.11 | $1,479.11 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $2,951.21 | Facility | None | $1,258.93 | $1,445.44 | $2,951.21 |
United Setting Professional Modifier None (both parts) Typical Low $851.14 Median $1,071.52 Typical High $1,621.81 | Professional | None (both parts) | $851.14 | $1,071.52 | $1,621.81 |
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 $489.78 Median $489.78 Typical High $691.83 | Professional | 52 · Reduced service | $489.78 | $489.78 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $275.42 | Professional | 53 · Discontinued | $194.98 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $204.17 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $138.04 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $138.04 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $616.60 Median $645.65 Typical High $1,548.82 | Professional | 26 · Professional part | $616.60 | $645.65 | $1,548.82 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,344.23 Typical High $5,754.40 | Professional | 50 · Both sides | $1,819.70 | $2,344.23 | $5,754.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $776.25 Typical High $1,905.46 | Professional | 51 · Multiple procedures | $616.60 | $776.25 | $1,905.46 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $309.03 Typical High $776.25 | Professional | 80 · Assistant surgeon | $245.47 | $309.03 | $776.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $218.78 Typical High $537.03 | Professional | 81 · Minimal assistant surgeon | $169.82 | $218.78 | $537.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $218.78 Typical High $537.03 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $218.78 | $537.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $218.78 Typical High $537.03 | Professional | AS · PA/NP assist | $169.82 | $218.78 | $537.03 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $933.25 Median $977.24 Typical High $2,290.87 | Professional | TC · Technical part | $933.25 | $977.24 | $2,290.87 |
Where South Carolina sits
The same service costs 2.7 times more in Hawaii than in Delaware. 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
$1,259
HI $3,162DE $1,175
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.