How much rates vary
Facilitymedian $1,549 · 10th to 90th $1,122 to $2,512Professionalmedian $1,445 · 10th to 90th $1,122 to $2,512
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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,122.02 Typical High $1,584.89 | Professional | None (both parts) | $1,122.02 | $1,122.02 | $1,584.89 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,290.87 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,290.87 | $2,511.89 | $2,511.89 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,445.44 Median $2,089.30 Typical High $2,511.89 | Professional | None (both parts) | $1,445.44 | $2,089.30 | $2,511.89 |
Cigna 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 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,122.02 Typical High $1,548.82 | Professional | None (both parts) | $1,122.02 | $1,122.02 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,479.11 | Professional | None | $1,445.44 | $1,445.44 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,348.96 Typical High $3,090.30 | Facility | None | $794.33 | $1,348.96 | $3,090.30 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,412.54 Median $1,778.28 Typical High $3,311.31 | Professional | None (both parts) | $1,412.54 | $1,778.28 | $3,311.31 |
Molina Setting Professional Modifier None (both parts) Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None (both parts) | $1,698.24 | $1,698.24 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $3,388.44 | Facility | None | $1,479.11 | $1,698.24 | $3,388.44 |
United Setting Professional Modifier None (both parts) Typical Low $977.24 Median $1,230.27 Typical High $1,862.09 | Professional | None (both parts) | $977.24 | $1,230.27 | $1,862.09 |
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 $549.54 Median $549.54 Typical High $794.33 | Professional | 52 · Reduced service | $549.54 | $549.54 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $316.23 | Professional | 53 · Discontinued | $223.87 | $223.87 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $234.42 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $158.49 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $158.49 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $707.95 Median $741.31 Typical High $1,778.28 | Professional | 26 · Professional part | $707.95 | $741.31 | $1,778.28 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,691.53 Typical High $6,606.93 | Professional | 50 · Both sides | $2,089.30 | $2,691.53 | $6,606.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $891.25 Typical High $2,187.76 | Professional | 51 · Multiple procedures | $691.83 | $891.25 | $2,187.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $354.81 Typical High $870.96 | Professional | 80 · Assistant surgeon | $281.84 | $354.81 | $870.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $251.19 Typical High $616.60 | Professional | 81 · Minimal assistant surgeon | $194.98 | $251.19 | $616.60 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $251.19 Typical High $616.60 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $251.19 | $616.60 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $251.19 Typical High $616.60 | Professional | AS · PA/NP assist | $194.98 | $251.19 | $616.60 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,071.52 Median $1,122.02 Typical High $2,630.27 | Professional | TC · Technical part | $1,071.52 | $1,122.02 | $2,630.27 |
Where South Carolina sits
The same service costs 3.0 times more in Iowa 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
$1,445
IA $3,311DE $1,122
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.