How much rates vary
Facilitymedian $1,318 · 10th to 90th $912 to $2,138Professionalmedian $2,089 · 10th to 90th $912 to $2,754
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 $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier None (both parts) Typical Low $912.01 Median $912.01 Typical High $1,288.25 | Professional | None (both parts) | $912.01 | $912.01 | $1,288.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,089.30 | Facility | None | $1,862.09 | $2,089.30 | $2,089.30 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,258.93 Median $2,089.30 Typical High $2,754.23 | Professional | None (both parts) | $1,258.93 | $2,089.30 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,412.54 | Facility | None | $1,318.26 | $1,318.26 | $1,412.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | None (both parts) | $954.99 | $954.99 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,023.29 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,000.00 Typical High $2,511.89 | Facility | None | $588.84 | $1,000.00 | $2,511.89 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,148.15 Median $1,479.11 Typical High $2,754.23 | Professional | None (both parts) | $1,148.15 | $1,479.11 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,454.71 Typical High $2,454.71 | Facility | None | $1,000.00 | $2,454.71 | $2,454.71 |
United Setting Professional Modifier None (both parts) Typical Low $758.58 Median $1,023.29 Typical High $1,380.38 | Professional | None (both parts) | $758.58 | $1,023.29 | $1,380.38 |
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 $457.09 Median $457.09 Typical High $645.65 | Professional | 52 · Reduced service | $457.09 | $457.09 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $257.04 | Professional | 53 · Discontinued | $181.97 | $181.97 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $194.98 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $128.82 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $128.82 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $588.84 Median $616.60 Typical High $1,445.44 | Professional | 26 · Professional part | $588.84 | $616.60 | $1,445.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,187.76 Typical High $5,495.41 | Professional | 50 · Both sides | $1,737.80 | $2,187.76 | $5,495.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $741.31 Typical High $1,819.70 | Professional | 51 · Multiple procedures | $575.44 | $741.31 | $1,819.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $295.12 Typical High $724.44 | Professional | 80 · Assistant surgeon | $229.09 | $295.12 | $724.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $162.18 Median $204.17 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $162.18 | $204.17 | $512.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $204.17 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $204.17 | $512.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $204.17 Typical High $512.86 | Professional | AS · PA/NP assist | $162.18 | $204.17 | $512.86 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $870.96 Median $933.25 Typical High $2,187.76 | Professional | TC · Technical part | $870.96 | $933.25 | $2,187.76 |
Where South Carolina sits
The same service costs 3.0 times more in Kansas 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· 4th of 51
$2,089
KS $2,818DE $955
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.