How much rates vary
Facilitymedian $6,607 · 10th to 90th $3,548 to $8,128Professionalmedian $4,786 · 10th to 90th $3,548 to $8,128
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 $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier None (both parts) Typical Low $3,548.13 Median $3,548.13 Typical High $5,128.61 | Professional | None (both parts) | $3,548.13 | $3,548.13 | $5,128.61 |
BCBS South Carolina Setting Facility Modifier None Typical Low $7,413.10 Median $8,128.31 Typical High $8,128.31 | Facility | None | $7,413.10 | $8,128.31 | $8,128.31 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $4,677.35 Median $6,606.93 Typical High $8,128.31 | Professional | None (both parts) | $4,677.35 | $6,606.93 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Cigna Setting Professional Modifier None (both parts) Typical Low $4,786.30 Median $4,786.30 Typical High $6,606.93 | Professional | None (both parts) | $4,786.30 | $4,786.30 | $6,606.93 |
Medcost Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $5,623.41 | Professional | None | $4,365.16 | $4,365.16 | $5,623.41 |
Medcost Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $9,772.37 | Facility | None | $2,570.40 | $4,073.80 | $9,772.37 |
Medcost Setting Professional Modifier None (both parts) Typical Low $4,466.84 Median $5,754.40 Typical High $10,715.19 | Professional | None (both parts) | $4,466.84 | $5,754.40 | $10,715.19 |
United Setting Facility Modifier None Typical Low $3,801.89 Median $4,466.84 Typical High $10,964.78 | Facility | None | $3,801.89 | $4,466.84 | $10,964.78 |
United Setting Professional Modifier None (both parts) Typical Low $3,162.28 Median $3,981.07 Typical High $6,025.60 | Professional | None (both parts) | $3,162.28 | $3,981.07 | $6,025.60 |
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 $1,778.28 Median $1,778.28 Typical High $2,511.89 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $724.44 Typical High $1,023.29 | Professional | 53 · Discontinued | $724.44 | $724.44 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $537.03 Typical High $758.58 | Professional | 55 · Aftercare only | $537.03 | $537.03 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $512.86 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $512.86 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $2,290.87 Median $2,398.83 Typical High $5,623.41 | Professional | 26 · Professional part | $2,290.87 | $2,398.83 | $5,623.41 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $6,760.83 Median $8,511.38 Typical High $21,379.62 | Professional | 50 · Both sides | $6,760.83 | $8,511.38 | $21,379.62 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2,238.72 Median $2,884.03 Typical High $7,079.46 | Professional | 51 · Multiple procedures | $2,238.72 | $2,884.03 | $7,079.46 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $891.25 Median $1,148.15 Typical High $2,818.38 | Professional | 80 · Assistant surgeon | $891.25 | $1,148.15 | $2,818.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $630.96 Median $794.33 Typical High $1,995.26 | Professional | 81 · Minimal assistant surgeon | $630.96 | $794.33 | $1,995.26 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $630.96 Median $794.33 Typical High $1,995.26 | Professional | 82 · Assistant surgeon, no resident | $630.96 | $794.33 | $1,995.26 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $630.96 Median $794.33 Typical High $1,995.26 | Professional | AS · PA/NP assist | $630.96 | $794.33 | $1,995.26 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $3,467.37 Median $3,630.78 Typical High $8,511.38 | Professional | TC · Technical part | $3,467.37 | $3,630.78 | $8,511.38 |
Where South Carolina sits
The same service costs 2.1 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· 43rd of 51
$4,786
MT $10,000PA $4,786
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.