How much rates vary
Facilitymedian $3,548 · 10th to 90th $2,291 to $5,248Professionalmedian $2,951 · 10th to 90th $2,291 to $5,248
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 $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,290.87 Median $2,290.87 Typical High $3,235.94 | Professional | None (both parts) | $2,290.87 | $2,290.87 | $3,235.94 |
BCBS South Carolina Setting Facility Modifier None Typical Low $4,677.35 Median $5,248.07 Typical High $5,248.07 | Facility | None | $4,677.35 | $5,248.07 | $5,248.07 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $2,951.21 Median $4,265.80 Typical High $5,248.07 | Professional | None (both parts) | $2,951.21 | $4,265.80 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Professional Modifier None (both parts) Typical Low $2,630.27 Median $2,630.27 Typical High $3,548.13 | Professional | None (both parts) | $2,630.27 | $2,630.27 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,019.95 | Professional | None | $2,398.83 | $2,398.83 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $2,511.89 Typical High $6,309.57 | Facility | None | $1,548.82 | $2,511.89 | $6,309.57 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,884.03 Median $3,630.78 Typical High $6,760.83 | Professional | None (both parts) | $2,884.03 | $3,630.78 | $6,760.83 |
Molina Setting Professional Modifier None (both parts) Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None (both parts) | $3,467.37 | $3,467.37 | $3,467.37 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $4,365.16 Typical High $6,606.93 | Facility | None | $3,235.94 | $4,365.16 | $6,606.93 |
United Setting Professional Modifier None (both parts) Typical Low $1,995.26 Median $2,570.40 Typical High $3,630.78 | Professional | None (both parts) | $1,995.26 | $2,570.40 | $3,630.78 |
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 $1,148.15 Median $1,148.15 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $645.65 | Professional | 53 · Discontinued | $457.09 | $457.09 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $478.63 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $323.59 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $323.59 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,445.44 Median $1,548.82 Typical High $3,630.78 | Professional | 26 · Professional part | $1,445.44 | $1,548.82 | $3,630.78 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $4,265.80 Median $5,495.41 Typical High $13,489.63 | Professional | 50 · Both sides | $4,265.80 | $5,495.41 | $13,489.63 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,445.44 Median $1,819.70 Typical High $4,466.84 | Professional | 51 · Multiple procedures | $1,445.44 | $1,819.70 | $4,466.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $575.44 Median $724.44 Typical High $1,819.70 | Professional | 80 · Assistant surgeon | $575.44 | $724.44 | $1,819.70 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $398.11 Median $512.86 Typical High $1,258.93 | Professional | 81 · Minimal assistant surgeon | $398.11 | $512.86 | $1,258.93 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $398.11 Median $512.86 Typical High $1,258.93 | Professional | 82 · Assistant surgeon, no resident | $398.11 | $512.86 | $1,258.93 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $398.11 Median $512.86 Typical High $1,258.93 | Professional | AS · PA/NP assist | $398.11 | $512.86 | $1,258.93 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $2,187.76 Median $2,290.87 Typical High $5,370.32 | Professional | TC · Technical part | $2,187.76 | $2,290.87 | $5,370.32 |
Where South Carolina sits
The same service costs 4.3 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· 32nd of 51
$2,951
HI $11,220PA $2,630
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.