How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,380 to $3,162Professionalmedian $1,820 · 10th to 90th $1,380 to $3,162
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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,380.38 Median $1,380.38 Typical High $1,949.84 | Professional | None (both parts) | $1,380.38 | $1,380.38 | $1,949.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,884.03 Median $3,162.28 Typical High $3,162.28 | Facility | None | $2,884.03 | $3,162.28 | $3,162.28 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,819.70 Median $2,570.40 Typical High $3,162.28 | Professional | None (both parts) | $1,819.70 | $2,570.40 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,819.70 Median $1,819.70 Typical High $2,454.71 | Professional | None (both parts) | $1,819.70 | $1,819.70 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,584.89 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $3,801.89 | Facility | None | $1,000.00 | $1,621.81 | $3,801.89 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,737.80 Median $2,238.72 Typical High $4,168.69 | Professional | None (both parts) | $1,737.80 | $2,238.72 | $4,168.69 |
Molina Setting Professional Modifier None (both parts) Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None (both parts) | $2,089.30 | $2,089.30 | $2,089.30 |
United Setting Facility Modifier None Typical Low $2,089.30 Median $2,187.76 Typical High $4,265.80 | Facility | None | $2,089.30 | $2,187.76 | $4,265.80 |
United Setting Professional Modifier None (both parts) Typical Low $1,202.26 Median $1,548.82 Typical High $2,344.23 | Professional | None (both parts) | $1,202.26 | $1,548.82 | $2,344.23 |
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 $691.83 Median $691.83 Typical High $977.24 | Professional | 52 · Reduced service | $691.83 | $691.83 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $389.05 | Professional | 53 · Discontinued | $275.42 | $275.42 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $295.12 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $194.98 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $194.98 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $891.25 Median $933.25 Typical High $2,187.76 | Professional | 26 · Professional part | $891.25 | $933.25 | $2,187.76 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,630.27 Median $3,311.31 Typical High $8,317.64 | Professional | 50 · Both sides | $2,630.27 | $3,311.31 | $8,317.64 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $1,122.02 Typical High $2,754.23 | Professional | 51 · Multiple procedures | $870.96 | $1,122.02 | $2,754.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $446.68 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $346.74 | $446.68 | $1,096.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $245.47 Median $309.03 Typical High $776.25 | Professional | 81 · Minimal assistant surgeon | $245.47 | $309.03 | $776.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $245.47 Median $309.03 Typical High $776.25 | Professional | 82 · Assistant surgeon, no resident | $245.47 | $309.03 | $776.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $309.03 Typical High $776.25 | Professional | AS · PA/NP assist | $245.47 | $309.03 | $776.25 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,348.96 Median $1,412.54 Typical High $3,311.31 | Professional | TC · Technical part | $1,348.96 | $1,412.54 | $3,311.31 |
Where South Carolina sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 41st of 51
$1,820
HI $5,623DC $1,660
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.