How much rates vary
Facilitymedian $7,244 · 10th to 90th $4,786 to $10,965Professionalmedian $6,310 · 10th to 90th $4,786 to $10,965
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 $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
Aetna 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 |
BCBS South Carolina Setting Facility Modifier None Typical Low $10,000.00 Median $10,964.78 Typical High $10,964.78 | Facility | None | $10,000.00 | $10,964.78 | $10,964.78 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $6,309.57 Median $8,912.51 Typical High $10,964.78 | Professional | None (both parts) | $6,309.57 | $8,912.51 | $10,964.78 |
Cigna Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
Cigna Setting Professional Modifier None (both parts) Typical Low $5,248.07 Median $5,248.07 Typical High $7,244.36 | Professional | None (both parts) | $5,248.07 | $5,248.07 | $7,244.36 |
Medcost Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $6,165.95 | Professional | None | $4,677.35 | $4,677.35 | $6,165.95 |
Medcost Setting Facility Modifier None Typical Low $2,951.21 Median $5,248.07 Typical High $13,182.57 | Facility | None | $2,951.21 | $5,248.07 | $13,182.57 |
Medcost Setting Professional Modifier None (both parts) Typical Low $6,025.60 Median $7,762.47 Typical High $14,454.40 | Professional | None (both parts) | $6,025.60 | $7,762.47 | $14,454.40 |
United Setting Facility Modifier None Typical Low $4,365.16 Median $5,128.61 Typical High $12,589.25 | Facility | None | $4,365.16 | $5,128.61 | $12,589.25 |
United Setting Professional Modifier None (both parts) Typical Low $3,801.89 Median $5,370.32 Typical High $6,918.31 | Professional | None (both parts) | $3,801.89 | $5,370.32 | $6,918.31 |
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 $2,398.83 Median $2,398.83 Typical High $3,311.31 | Professional | 52 · Reduced service | $2,398.83 | $2,398.83 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | 53 · Discontinued | $954.99 | $954.99 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $724.44 Typical High $1,000.00 | Professional | 55 · Aftercare only | $724.44 | $724.44 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $478.63 Typical High $660.69 | Professional | 56 · Pre-op care only | $478.63 | $478.63 | $660.69 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $3,090.30 Median $3,235.94 Typical High $7,585.78 | Professional | 26 · Professional part | $3,090.30 | $3,235.94 | $7,585.78 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $9,120.11 Median $11,481.54 Typical High $28,840.32 | Professional | 50 · Both sides | $9,120.11 | $11,481.54 | $28,840.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3,019.95 Median $3,890.45 Typical High $9,549.93 | Professional | 51 · Multiple procedures | $3,019.95 | $3,890.45 | $9,549.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,202.26 Median $1,548.82 Typical High $3,801.89 | Professional | 80 · Assistant surgeon | $1,202.26 | $1,548.82 | $3,801.89 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $851.14 Median $1,071.52 Typical High $2,691.53 | Professional | 81 · Minimal assistant surgeon | $851.14 | $1,071.52 | $2,691.53 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $851.14 Median $1,071.52 Typical High $2,691.53 | Professional | 82 · Assistant surgeon, no resident | $851.14 | $1,071.52 | $2,691.53 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $851.14 Median $1,071.52 Typical High $2,691.53 | Professional | AS · PA/NP assist | $851.14 | $1,071.52 | $2,691.53 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $4,677.35 Median $4,897.79 Typical High $11,481.54 | Professional | TC · Technical part | $4,677.35 | $4,897.79 | $11,481.54 |
Where South Carolina sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 27th of 51
$6,310
HI $11,220NJ $5,248
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.