How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,738 to $3,981Professionalmedian $2,239 · 10th to 90th $1,738 to $3,981
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 $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,737.80 Median $1,737.80 Typical High $2,454.71 | Professional | None (both parts) | $1,737.80 | $1,737.80 | $2,454.71 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,548.13 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,548.13 | $3,981.07 | $3,981.07 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $2,238.72 Median $3,235.94 Typical High $3,981.07 | Professional | None (both parts) | $2,238.72 | $3,235.94 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
Cigna Setting Professional Modifier None (both parts) Typical Low $2,187.76 Median $2,187.76 Typical High $2,951.21 | Professional | None (both parts) | $2,187.76 | $2,187.76 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,862.09 | $1,862.09 | $2,238.72 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $2,041.74 Typical High $4,786.30 | Facility | None | $1,202.26 | $2,041.74 | $4,786.30 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,187.76 Median $2,818.38 Typical High $5,128.61 | Professional | None (both parts) | $2,187.76 | $2,818.38 | $5,128.61 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $2,951.21 Typical High $5,011.87 | Facility | None | $2,041.74 | $2,951.21 | $5,011.87 |
United Setting Professional Modifier None (both parts) Typical Low $1,513.56 Median $1,949.84 Typical High $2,754.23 | Professional | None (both parts) | $1,513.56 | $1,949.84 | $2,754.23 |
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 $870.96 Median $870.96 Typical High $1,230.27 | Professional | 52 · Reduced service | $870.96 | $870.96 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $489.78 | Professional | 53 · Discontinued | $346.74 | $346.74 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $371.54 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $245.47 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $245.47 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,122.02 Median $1,174.90 Typical High $2,754.23 | Professional | 26 · Professional part | $1,122.02 | $1,174.90 | $2,754.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,311.31 Median $4,168.69 Typical High $10,232.93 | Professional | 50 · Both sides | $3,311.31 | $4,168.69 | $10,232.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,096.48 Median $1,380.38 Typical High $3,467.37 | Professional | 51 · Multiple procedures | $1,096.48 | $1,380.38 | $3,467.37 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $562.34 Typical High $1,380.38 | Professional | 80 · Assistant surgeon | $436.52 | $562.34 | $1,380.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $309.03 Median $389.05 Typical High $954.99 | Professional | 81 · Minimal assistant surgeon | $309.03 | $389.05 | $954.99 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $309.03 Median $389.05 Typical High $954.99 | Professional | 82 · Assistant surgeon, no resident | $309.03 | $389.05 | $954.99 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $389.05 Typical High $954.99 | Professional | AS · PA/NP assist | $309.03 | $389.05 | $954.99 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,659.59 Median $1,737.80 Typical High $4,168.69 | Professional | TC · Technical part | $1,659.59 | $1,737.80 | $4,168.69 |
Where South Carolina sits
The same service costs 2.5 times more in Montana 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· 35th of 51
$2,239
MT $4,898DC $1,995
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.