How much rates vary
Facilitymedian $1,660 · 10th to 90th $1,259 to $3,090Professionalmedian $1,738 · 10th to 90th $1,380 to $3,090
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 $1,819.70 | Professional | None (both parts) | $1,380.38 | $1,380.38 | $1,819.70 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,818.38 Median $3,090.30 Typical High $3,090.30 | Facility | None | $2,818.38 | $3,090.30 | $3,090.30 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,737.80 Median $2,511.89 Typical High $3,090.30 | Professional | None (both parts) | $1,737.80 | $2,511.89 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,202.26 Median $1,202.26 Typical High $1,819.70 | Professional | None (both parts) | $1,202.26 | $1,202.26 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,380.38 | Professional | None | $1,148.15 | $1,148.15 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,513.56 Typical High $3,801.89 | Facility | None | $741.31 | $1,513.56 | $3,801.89 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,698.24 Median $2,187.76 Typical High $4,073.80 | Professional | None (both parts) | $1,698.24 | $2,187.76 | $4,073.80 |
Molina Setting Professional Modifier None (both parts) Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None (both parts) | $2,041.74 | $2,041.74 | $2,041.74 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,258.93 Typical High $3,090.30 | Facility | None | $977.24 | $1,258.93 | $3,090.30 |
United Setting Professional Modifier None (both parts) Typical Low $1,023.29 Median $1,513.56 Typical High $1,819.70 | Professional | None (both parts) | $1,023.29 | $1,513.56 | $1,819.70 |
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 $676.08 Median $676.08 Typical High $912.01 | Professional | 52 · Reduced service | $676.08 | $676.08 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $363.08 | Professional | 53 · Discontinued | $275.42 | $275.42 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $181.97 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $181.97 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $870.96 Median $912.01 Typical High $2,137.96 | Professional | 26 · Professional part | $870.96 | $912.01 | $2,137.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,570.40 Median $3,311.31 Typical High $8,128.31 | Professional | 50 · Both sides | $2,570.40 | $3,311.31 | $8,128.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $851.14 Median $1,096.48 Typical High $2,691.53 | Professional | 51 · Multiple procedures | $851.14 | $1,096.48 | $2,691.53 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $436.52 Typical High $1,071.52 | Professional | 80 · Assistant surgeon | $346.74 | $436.52 | $1,071.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $309.03 Typical High $758.58 | Professional | 81 · Minimal assistant surgeon | $239.88 | $309.03 | $758.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $309.03 Typical High $758.58 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $309.03 | $758.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $309.03 Typical High $758.58 | Professional | AS · PA/NP assist | $239.88 | $309.03 | $758.58 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,318.26 Median $1,380.38 Typical High $3,235.94 | Professional | TC · Technical part | $1,318.26 | $1,380.38 | $3,235.94 |
Where South Carolina sits
The same service costs 2.4 times more in Hawaii than in Vermont. 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· 21st of 51
$1,738
HI $2,884VT $1,202
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.