How much rates vary
Facilitymedian $1,230 · 10th to 90th $871 to $1,995Professionalmedian $1,122 · 10th to 90th $871 to $1,995
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 $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier None (both parts) Typical Low $870.96 Median $870.96 Typical High $1,230.27 | Professional | None (both parts) | $870.96 | $870.96 | $1,230.27 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,778.28 | $1,995.26 | $1,995.26 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,621.81 Typical High $1,995.26 | Professional | None (both parts) | $1,122.02 | $1,621.81 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Professional Modifier None (both parts) Typical Low $891.25 Median $891.25 Typical High $1,230.27 | Professional | None (both parts) | $891.25 | $891.25 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | None | $977.24 | $977.24 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $1,023.29 Typical High $2,398.83 | Facility | None | $616.60 | $1,023.29 | $2,398.83 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,096.48 Median $1,380.38 Typical High $2,570.40 | Professional | None (both parts) | $1,096.48 | $1,380.38 | $2,570.40 |
Molina Setting Professional Modifier None (both parts) Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None (both parts) | $1,318.26 | $1,318.26 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $2,630.27 | Facility | None | $1,071.52 | $1,202.26 | $2,630.27 |
United Setting Professional Modifier None (both parts) Typical Low $758.58 Median $954.99 Typical High $1,445.44 | Professional | None (both parts) | $758.58 | $954.99 | $1,445.44 |
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 $436.52 Median $436.52 Typical High $616.60 | Professional | 52 · Reduced service | $436.52 | $436.52 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $245.47 | Professional | 53 · Discontinued | $173.78 | $173.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $181.97 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $123.03 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $123.03 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $549.54 Median $575.44 Typical High $1,380.38 | Professional | 26 · Professional part | $549.54 | $575.44 | $1,380.38 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,089.30 Typical High $5,128.61 | Professional | 50 · Both sides | $1,621.81 | $2,089.30 | $5,128.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $691.83 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $549.54 | $691.83 | $1,698.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $275.42 Typical High $691.83 | Professional | 80 · Assistant surgeon | $218.78 | $275.42 | $691.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $194.98 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $151.36 | $194.98 | $478.63 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $194.98 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $194.98 | $478.63 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $194.98 Typical High $478.63 | Professional | AS · PA/NP assist | $151.36 | $194.98 | $478.63 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $831.76 Median $870.96 Typical High $2,041.74 | Professional | TC · Technical part | $831.76 | $870.96 | $2,041.74 |
Where South Carolina sits
The same service costs 3.1 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· 43rd of 51
$1,122
HI $2,754DE $891
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.