How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,549 to $3,548Professionalmedian $2,042 · 10th to 90th $1,549 to $3,548
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 $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,548.82 Median $1,548.82 Typical High $2,187.76 | Professional | None (both parts) | $1,548.82 | $1,548.82 | $2,187.76 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,162.28 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,162.28 | $3,548.13 | $3,548.13 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $2,041.74 Median $2,884.03 Typical High $3,548.13 | Professional | None (both parts) | $2,041.74 | $2,884.03 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,862.09 Median $1,862.09 Typical High $2,570.40 | Professional | None (both parts) | $1,862.09 | $1,862.09 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,862.09 | Professional | None | $1,698.24 | $1,698.24 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $1,698.24 Typical High $4,265.80 | Facility | None | $1,000.00 | $1,698.24 | $4,265.80 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,949.84 Median $2,511.89 Typical High $4,677.35 | Professional | None (both parts) | $1,949.84 | $2,511.89 | $4,677.35 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $4,168.69 | Facility | None | $1,288.25 | $1,659.59 | $4,168.69 |
United Setting Professional Modifier None (both parts) Typical Low $1,288.25 Median $1,737.80 Typical High $2,290.87 | Professional | None (both parts) | $1,288.25 | $1,737.80 | $2,290.87 |
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 $776.25 Median $776.25 Typical High $1,096.48 | Professional | 52 · Reduced service | $776.25 | $776.25 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $436.52 | Professional | 53 · Discontinued | $309.03 | $309.03 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $331.13 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $218.78 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $218.78 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,000.00 Median $1,047.13 Typical High $2,454.71 | Professional | 26 · Professional part | $1,000.00 | $1,047.13 | $2,454.71 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,951.21 Median $3,715.35 Typical High $9,332.54 | Professional | 50 · Both sides | $2,951.21 | $3,715.35 | $9,332.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $977.24 Median $1,258.93 Typical High $3,090.30 | Professional | 51 · Multiple procedures | $977.24 | $1,258.93 | $3,090.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $501.19 Typical High $1,230.27 | Professional | 80 · Assistant surgeon | $389.05 | $501.19 | $1,230.27 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $275.42 Median $346.74 Typical High $870.96 | Professional | 81 · Minimal assistant surgeon | $275.42 | $346.74 | $870.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $275.42 Median $346.74 Typical High $870.96 | Professional | 82 · Assistant surgeon, no resident | $275.42 | $346.74 | $870.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $346.74 Typical High $870.96 | Professional | AS · PA/NP assist | $275.42 | $346.74 | $870.96 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,513.56 Median $1,584.89 Typical High $3,715.35 | Professional | TC · Technical part | $1,513.56 | $1,584.89 | $3,715.35 |
Where South Carolina sits
The same service costs 2.4 times more in Wisconsin 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· 29th of 51
$2,042
WI $3,981DC $1,660
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.