How much rates vary
Facilitymedian $1,318 · 10th to 90th $813 to $1,862Professionalmedian $1,047 · 10th to 90th $813 to $1,862
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 $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $812.83 Median $812.83 Typical High $1,122.02 | Professional | None (both parts) | $812.83 | $812.83 | $1,122.02 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,659.59 | $1,862.09 | $1,862.09 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $1,047.13 Median $1,513.56 Typical High $1,862.09 | Professional | None (both parts) | $1,047.13 | $1,513.56 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Professional Modifier None (both parts) Typical Low $977.24 Median $977.24 Typical High $1,318.26 | Professional | None (both parts) | $977.24 | $977.24 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Professional | None | $912.01 | $912.01 | $1,000.00 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $891.25 Typical High $2,238.72 | Facility | None | $537.03 | $891.25 | $2,238.72 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,023.29 Median $1,288.25 Typical High $2,398.83 | Professional | None (both parts) | $1,023.29 | $1,288.25 | $2,398.83 |
Molina Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None (both parts) | $1,230.27 | $1,230.27 | $1,230.27 |
United Setting Facility Modifier None Typical Low $645.65 Median $831.76 Typical High $2,238.72 | Facility | None | $645.65 | $831.76 | $2,238.72 |
United Setting Professional Modifier None (both parts) Typical Low $691.83 Median $912.01 Typical High $1,230.27 | Professional | None (both parts) | $691.83 | $912.01 | $1,230.27 |
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 $407.38 Median $407.38 Typical High $562.34 | Professional | 52 · Reduced service | $407.38 | $407.38 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $223.87 | Professional | 53 · Discontinued | $162.18 | $162.18 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $165.96 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $112.20 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $112.20 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $524.81 Median $549.54 Typical High $1,288.25 | Professional | 26 · Professional part | $524.81 | $549.54 | $1,288.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,949.84 Typical High $4,786.30 | Professional | 50 · Both sides | $1,548.82 | $1,949.84 | $4,786.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $645.65 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $512.86 | $645.65 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $263.03 Typical High $645.65 | Professional | 80 · Assistant surgeon | $204.17 | $263.03 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $181.97 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $144.54 | $181.97 | $446.68 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $181.97 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $181.97 | $446.68 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $181.97 Typical High $446.68 | Professional | AS · PA/NP assist | $144.54 | $181.97 | $446.68 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $776.25 Median $812.83 Typical High $1,949.84 | Professional | TC · Technical part | $776.25 | $812.83 | $1,949.84 |
Where South Carolina sits
The same service costs 2.5 times more in Montana 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· 31st of 51
$1,047
MT $2,239PA $891
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.