How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,905 to $4,266Professionalmedian $2,344 · 10th to 90th $1,698 to $4,266
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 $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,905.46 Median $1,905.46 Typical High $2,691.53 | Professional | None (both parts) | $1,905.46 | $1,905.46 | $2,691.53 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,890.45 Median $4,265.80 Typical High $4,265.80 | Facility | None | $3,890.45 | $4,265.80 | $4,265.80 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,698.24 Median $2,754.23 Typical High $4,265.80 | Professional | None (both parts) | $1,698.24 | $2,754.23 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,388.44 | $3,388.44 | $3,388.44 |
Cigna Setting Professional Modifier None (both parts) Typical Low $2,454.71 Median $2,454.71 Typical High $3,388.44 | Professional | None (both parts) | $2,454.71 | $2,454.71 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,630.27 | Professional | None | $2,089.30 | $2,089.30 | $2,630.27 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $2,238.72 Typical High $5,248.07 | Facility | None | $1,318.26 | $2,238.72 | $5,248.07 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,344.23 Median $3,019.95 Typical High $5,623.41 | Professional | None (both parts) | $2,344.23 | $3,019.95 | $5,623.41 |
Molina Setting Professional Modifier None (both parts) Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None (both parts) | $2,818.38 | $2,818.38 | $2,818.38 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,495.41 Typical High $5,495.41 | Facility | None | $2,398.83 | $5,495.41 | $5,495.41 |
United Setting Professional Modifier None (both parts) Typical Low $1,659.59 Median $2,089.30 Typical High $3,090.30 | Professional | None (both parts) | $1,659.59 | $2,089.30 | $3,090.30 |
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 $933.25 Median $933.25 Typical High $1,318.26 | Professional | 52 · Reduced service | $933.25 | $933.25 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $537.03 | Professional | 53 · Discontinued | $380.19 | $380.19 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $398.11 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $269.15 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $269.15 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,202.26 Median $1,258.93 Typical High $2,951.21 | Professional | 26 · Professional part | $1,202.26 | $1,258.93 | $2,951.21 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,548.13 Median $4,570.88 Typical High $11,220.18 | Professional | 50 · Both sides | $3,548.13 | $4,570.88 | $11,220.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,174.90 Median $1,513.56 Typical High $3,715.35 | Professional | 51 · Multiple procedures | $1,174.90 | $1,513.56 | $3,715.35 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $478.63 Median $602.56 Typical High $1,479.11 | Professional | 80 · Assistant surgeon | $478.63 | $602.56 | $1,479.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $331.13 Median $426.58 Typical High $1,047.13 | Professional | 81 · Minimal assistant surgeon | $331.13 | $426.58 | $1,047.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $331.13 Median $426.58 Typical High $1,047.13 | Professional | 82 · Assistant surgeon, no resident | $331.13 | $426.58 | $1,047.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $331.13 Median $426.58 Typical High $1,047.13 | Professional | AS · PA/NP assist | $331.13 | $426.58 | $1,047.13 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,819.70 Median $1,905.46 Typical High $4,466.84 | Professional | TC · Technical part | $1,819.70 | $1,905.46 | $4,466.84 |
Where South Carolina sits
The same service costs 2.1 times more in Montana than in South Carolina. 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· 51st of 51
$2,344
MT $4,898SC $2,344
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.