How much rates vary
Facilitymedian $955 · 10th to 90th $708 to $1,622Professionalmedian $955 · 10th to 90th $708 to $1,622
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 $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier None (both parts) Typical Low $707.95 Median $707.95 Typical High $1,000.00 | Professional | None (both parts) | $707.95 | $707.95 | $1,000.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,479.11 | $1,621.81 | $1,621.81 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $954.99 Median $1,380.38 Typical High $1,621.81 | Professional | None (both parts) | $954.99 | $1,380.38 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Professional Modifier None (both parts) Typical Low $691.83 Median $691.83 Typical High $954.99 | Professional | None (both parts) | $691.83 | $691.83 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $933.25 | Professional | None | $794.33 | $794.33 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $1,949.84 | Facility | None | $457.09 | $794.33 | $1,949.84 |
Medcost Setting Professional Modifier None (both parts) Typical Low $891.25 Median $1,148.15 Typical High $2,137.96 | Professional | None (both parts) | $891.25 | $1,148.15 | $2,137.96 |
Molina Setting Professional Modifier None (both parts) Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None (both parts) | $1,071.52 | $1,071.52 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
United Setting Professional Modifier None (both parts) Typical Low $588.84 Median $794.33 Typical High $1,071.52 | Professional | None (both parts) | $588.84 | $794.33 | $1,071.52 |
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 $354.81 Median $354.81 Typical High $501.19 | Professional | 52 · Reduced service | $354.81 | $354.81 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $199.53 | Professional | 53 · Discontinued | $141.25 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $151.36 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $100.00 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $100.00 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $457.09 Median $478.63 Typical High $1,122.02 | Professional | 26 · Professional part | $457.09 | $478.63 | $1,122.02 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,698.24 Typical High $4,265.80 | Professional | 50 · Both sides | $1,348.96 | $1,698.24 | $4,265.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $575.44 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $446.68 | $575.44 | $1,412.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $229.09 Typical High $562.34 | Professional | 80 · Assistant surgeon | $177.83 | $229.09 | $562.34 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $125.89 Median $158.49 Typical High $398.11 | Professional | 81 · Minimal assistant surgeon | $125.89 | $158.49 | $398.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $158.49 Typical High $398.11 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $158.49 | $398.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $158.49 Typical High $398.11 | Professional | AS · PA/NP assist | $125.89 | $158.49 | $398.11 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $691.83 Median $724.44 Typical High $1,698.24 | Professional | TC · Technical part | $691.83 | $724.44 | $1,698.24 |
Where South Carolina sits
The same service costs 2.4 times more in Montana 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· 35th of 51
$955
MT $1,660DE $692
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.