How much rates vary
Facilitymedian $1,778 · 10th to 90th $1,096 to $2,455Professionalmedian $1,413 · 10th to 90th $1,096 to $2,455
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 $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,096.48 Median $1,096.48 Typical High $1,548.82 | Professional | None (both parts) | $1,096.48 | $1,096.48 | $1,548.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,238.72 | $2,454.71 | $2,454.71 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,412.54 Median $2,041.74 Typical High $2,454.71 | Professional | None (both parts) | $1,412.54 | $2,041.74 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None (both parts) | $1,288.25 | $1,288.25 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,445.44 | $1,513.56 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $776.25 Median $1,288.25 Typical High $3,019.95 | Facility | None | $776.25 | $1,288.25 | $3,019.95 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,348.96 Median $1,737.80 Typical High $3,235.94 | Professional | None (both parts) | $1,348.96 | $1,737.80 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $3,311.31 | Facility | None | $1,412.54 | $1,548.82 | $3,311.31 |
United Setting Professional Modifier None (both parts) Typical Low $954.99 Median $1,202.26 Typical High $1,819.70 | Professional | None (both parts) | $954.99 | $1,202.26 | $1,819.70 |
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 $537.03 Median $537.03 Typical High $776.25 | Professional | 52 · Reduced service | $537.03 | $537.03 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $309.03 | Professional | 53 · Discontinued | $218.78 | $218.78 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $229.09 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $154.88 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $154.88 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $691.83 Median $724.44 Typical High $1,698.24 | Professional | 26 · Professional part | $691.83 | $724.44 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,630.27 Typical High $6,456.54 | Professional | 50 · Both sides | $2,041.74 | $2,630.27 | $6,456.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $676.08 Median $870.96 Typical High $2,137.96 | Professional | 51 · Multiple procedures | $676.08 | $870.96 | $2,137.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $346.74 Typical High $851.14 | Professional | 80 · Assistant surgeon | $275.42 | $346.74 | $851.14 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $245.47 Typical High $602.56 | Professional | 81 · Minimal assistant surgeon | $190.55 | $245.47 | $602.56 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $245.47 Typical High $602.56 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $245.47 | $602.56 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $245.47 Typical High $602.56 | Professional | AS · PA/NP assist | $190.55 | $245.47 | $602.56 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,047.13 Median $1,096.48 Typical High $2,570.40 | Professional | TC · Technical part | $1,047.13 | $1,096.48 | $2,570.40 |
Where South Carolina sits
The same service costs 2.7 times more in Hawaii than in Maryland. 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
$1,413
HI $3,467MD $1,288
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.