How much rates vary
Facilitymedian $1,820 · 10th to 90th $1,148 to $2,951Professionalmedian $1,660 · 10th to 90th $1,288 to $2,951
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 $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,288.25 Median $1,288.25 Typical High $2,089.30 | Professional | None (both parts) | $1,288.25 | $1,288.25 | $2,089.30 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None (both parts) | $3,090.30 | $3,090.30 | $3,090.30 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,630.27 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,630.27 | $2,951.21 | $2,951.21 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,659.59 Median $2,398.83 Typical High $2,951.21 | Professional | None (both parts) | $1,659.59 | $2,398.83 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,318.26 Median $1,318.26 Typical High $1,819.70 | Professional | None (both parts) | $1,318.26 | $1,318.26 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,412.54 Typical High $3,548.13 | Facility | None | $741.31 | $1,412.54 | $3,548.13 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,621.81 Median $2,041.74 Typical High $3,801.89 | Professional | None (both parts) | $1,621.81 | $2,041.74 | $3,801.89 |
Molina Setting Professional Modifier None (both parts) Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None (both parts) | $1,949.84 | $1,949.84 | $1,949.84 |
United Setting Facility Modifier None Typical Low $870.96 Median $1,148.15 Typical High $3,090.30 | Facility | None | $870.96 | $1,148.15 | $3,090.30 |
United Setting Professional Modifier None (both parts) Typical Low $954.99 Median $1,412.54 Typical High $1,737.80 | Professional | None (both parts) | $954.99 | $1,412.54 | $1,737.80 |
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 $645.65 Median $645.65 Typical High $851.14 | Professional | 52 · Reduced service | $645.65 | $645.65 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $346.74 | Professional | 53 · Discontinued | $257.04 | $257.04 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $257.04 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $169.82 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $812.83 Median $851.14 Typical High $2,041.74 | Professional | 26 · Professional part | $812.83 | $851.14 | $2,041.74 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $3,090.30 Typical High $7,585.78 | Professional | 50 · Both sides | $2,398.83 | $3,090.30 | $7,585.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $812.83 Median $1,023.29 Typical High $2,511.89 | Professional | 51 · Multiple procedures | $812.83 | $1,023.29 | $2,511.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $407.38 Typical High $1,023.29 | Professional | 80 · Assistant surgeon | $323.59 | $407.38 | $1,023.29 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $288.40 Typical High $707.95 | Professional | 81 · Minimal assistant surgeon | $223.87 | $288.40 | $707.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $288.40 Typical High $707.95 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $288.40 | $707.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $288.40 Typical High $707.95 | Professional | AS · PA/NP assist | $223.87 | $288.40 | $707.95 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,230.27 Median $1,288.25 Typical High $3,019.95 | Professional | TC · Technical part | $1,230.27 | $1,288.25 | $3,019.95 |
Where South Carolina sits
The same service costs 2.3 times more in Wisconsin 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· 29th of 51
$1,660
WI $2,951PA $1,288
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.