How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,622 to $3,631Professionalmedian $2,089 · 10th to 90th $1,622 to $3,631
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 $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,621.81 Median $1,621.81 Typical High $2,691.53 | Professional | None (both parts) | $1,621.81 | $1,621.81 | $2,691.53 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $1,778.28 Median $1,778.28 Typical High $3,801.89 | Professional | None (both parts) | $1,778.28 | $1,778.28 | $3,801.89 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,311.31 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,311.31 | $3,630.78 | $3,630.78 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $2,089.30 Median $3,019.95 Typical High $3,630.78 | Professional | None (both parts) | $2,089.30 | $3,019.95 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,584.89 Median $1,584.89 Typical High $2,137.96 | Professional | None (both parts) | $1,584.89 | $1,584.89 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,819.70 | $1,819.70 | $2,290.87 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,819.70 Typical High $4,466.84 | Facility | None | $1,122.02 | $1,819.70 | $4,466.84 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,041.74 Median $2,570.40 Typical High $4,786.30 | Professional | None (both parts) | $2,041.74 | $2,570.40 | $4,786.30 |
Molina Setting Professional Modifier None (both parts) Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None (both parts) | $2,454.71 | $2,454.71 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,677.35 Typical High $4,677.35 | Facility | None | $1,949.84 | $4,677.35 | $4,677.35 |
United Setting Professional Modifier None (both parts) Typical Low $1,412.54 Median $1,778.28 Typical High $2,570.40 | Professional | None (both parts) | $1,412.54 | $1,778.28 | $2,570.40 |
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 $812.83 Median $812.83 Typical High $1,148.15 | Professional | 52 · Reduced service | $812.83 | $812.83 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $457.09 | Professional | 53 · Discontinued | $323.59 | $323.59 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $338.84 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $229.09 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $229.09 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,023.29 Median $1,071.52 Typical High $2,570.40 | Professional | 26 · Professional part | $1,023.29 | $1,071.52 | $2,570.40 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,019.95 Median $3,890.45 Typical High $9,549.93 | Professional | 50 · Both sides | $3,019.95 | $3,890.45 | $9,549.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,000.00 Median $1,288.25 Typical High $3,162.28 | Professional | 51 · Multiple procedures | $1,000.00 | $1,288.25 | $3,162.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $512.86 Typical High $1,258.93 | Professional | 80 · Assistant surgeon | $407.38 | $512.86 | $1,258.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $281.84 Median $363.08 Typical High $891.25 | Professional | 81 · Minimal assistant surgeon | $281.84 | $363.08 | $891.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $281.84 Median $363.08 Typical High $891.25 | Professional | 82 · Assistant surgeon, no resident | $281.84 | $363.08 | $891.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $363.08 Typical High $891.25 | Professional | AS · PA/NP assist | $281.84 | $363.08 | $891.25 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,548.82 Median $1,621.81 Typical High $3,801.89 | Professional | TC · Technical part | $1,548.82 | $1,621.81 | $3,801.89 |
Where South Carolina sits
The same service costs 2.6 times more in Wisconsin 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· 39th of 51
$2,089
WI $4,074DE $1,585
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.