How much rates vary
Facilitymedian $3,548 · 10th to 90th $2,089 to $4,786Professionalmedian $2,692 · 10th to 90th $2,089 to $4,786
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 $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,089.30 Median $2,089.30 Typical High $2,951.21 | Professional | None (both parts) | $2,089.30 | $2,089.30 | $2,951.21 |
BCBS South Carolina Setting Facility Modifier None Typical Low $4,265.80 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,265.80 | $4,786.30 | $4,786.30 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $2,691.53 Median $3,890.45 Typical High $4,786.30 | Professional | None (both parts) | $2,691.53 | $3,890.45 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Professional Modifier None (both parts) Typical Low $2,570.40 Median $2,570.40 Typical High $3,548.13 | Professional | None (both parts) | $2,570.40 | $2,570.40 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,754.23 | Professional | None | $2,290.87 | $2,290.87 | $2,754.23 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $2,290.87 Typical High $5,754.40 | Facility | None | $1,479.11 | $2,290.87 | $5,754.40 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,630.27 Median $3,388.44 Typical High $6,165.95 | Professional | None (both parts) | $2,630.27 | $3,388.44 | $6,165.95 |
Molina Setting Professional Modifier None (both parts) Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None (both parts) | $3,162.28 | $3,162.28 | $3,162.28 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $3,890.45 Typical High $6,165.95 | Facility | None | $3,019.95 | $3,890.45 | $6,165.95 |
United Setting Professional Modifier None (both parts) Typical Low $1,819.70 Median $2,344.23 Typical High $3,467.37 | Professional | None (both parts) | $1,819.70 | $2,344.23 | $3,467.37 |
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 $1,047.13 Median $1,047.13 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $588.84 | Professional | 53 · Discontinued | $416.87 | $416.87 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $446.68 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $295.12 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $295.12 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,348.96 Median $1,412.54 Typical High $3,311.31 | Professional | 26 · Professional part | $1,348.96 | $1,412.54 | $3,311.31 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,981.07 Median $5,011.87 Typical High $12,302.69 | Professional | 50 · Both sides | $3,981.07 | $5,011.87 | $12,302.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,318.26 Median $1,659.59 Typical High $4,168.69 | Professional | 51 · Multiple procedures | $1,318.26 | $1,659.59 | $4,168.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $676.08 Typical High $1,659.59 | Professional | 80 · Assistant surgeon | $524.81 | $676.08 | $1,659.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $371.54 Median $467.74 Typical High $1,148.15 | Professional | 81 · Minimal assistant surgeon | $371.54 | $467.74 | $1,148.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $371.54 Median $467.74 Typical High $1,148.15 | Professional | 82 · Assistant surgeon, no resident | $371.54 | $467.74 | $1,148.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $467.74 Typical High $1,148.15 | Professional | AS · PA/NP assist | $371.54 | $467.74 | $1,148.15 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,995.26 Median $2,089.30 Typical High $5,011.87 | Professional | TC · Technical part | $1,995.26 | $2,089.30 | $5,011.87 |
Where South Carolina sits
The same service costs 3.0 times more in Hawaii than in Pennsylvania. 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
$2,692
HI $7,413PA $2,455
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.