How much rates vary
Facilitymedian $7,586 · 10th to 90th $4,786 to $11,220Professionalmedian $6,310 · 10th to 90th $4,898 to $11,220
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 $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
Aetna Setting Professional Modifier None (both parts) Typical Low $4,897.79 Median $4,897.79 Typical High $6,918.31 | Professional | None (both parts) | $4,897.79 | $4,897.79 | $6,918.31 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | None (both parts) | $8,511.38 | $8,511.38 | $8,511.38 |
BCBS South Carolina Setting Facility Modifier None Typical Low $10,000.00 Median $11,220.18 Typical High $11,220.18 | Facility | None | $10,000.00 | $11,220.18 | $11,220.18 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $6,309.57 Median $9,120.11 Typical High $11,220.18 | Professional | None (both parts) | $6,309.57 | $9,120.11 | $11,220.18 |
Cigna Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
Cigna Setting Professional Modifier None (both parts) Typical Low $5,495.41 Median $5,495.41 Typical High $7,585.78 | Professional | None (both parts) | $5,495.41 | $5,495.41 | $7,585.78 |
Medcost Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $6,165.95 | Professional | None | $5,248.07 | $5,248.07 | $6,165.95 |
Medcost Setting Facility Modifier None Typical Low $3,019.95 Median $5,370.32 Typical High $13,489.63 | Facility | None | $3,019.95 | $5,370.32 | $13,489.63 |
Medcost Setting Professional Modifier None (both parts) Typical Low $6,165.95 Median $7,762.47 Typical High $14,454.40 | Professional | None (both parts) | $6,165.95 | $7,762.47 | $14,454.40 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $4,786.30 Typical High $12,882.50 | Facility | None | $4,265.80 | $4,786.30 | $12,882.50 |
United Setting Professional Modifier None (both parts) Typical Low $3,890.45 Median $5,495.41 Typical High $7,079.46 | Professional | None (both parts) | $3,890.45 | $5,495.41 | $7,079.46 |
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 $2,454.71 Median $2,454.71 Typical High $3,467.37 | Professional | 52 · Reduced service | $2,454.71 | $2,454.71 | $3,467.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $977.24 Typical High $1,380.38 | Professional | 53 · Discontinued | $977.24 | $977.24 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $741.31 Median $741.31 Typical High $1,047.13 | Professional | 55 · Aftercare only | $741.31 | $741.31 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $489.78 Median $489.78 Typical High $691.83 | Professional | 56 · Pre-op care only | $489.78 | $489.78 | $691.83 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $3,162.28 Median $3,311.31 Typical High $7,762.47 | Professional | 26 · Professional part | $3,162.28 | $3,311.31 | $7,762.47 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $9,332.54 Median $11,748.98 Typical High $28,840.32 | Professional | 50 · Both sides | $9,332.54 | $11,748.98 | $28,840.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3,090.30 Median $3,890.45 Typical High $9,772.37 | Professional | 51 · Multiple procedures | $3,090.30 | $3,890.45 | $9,772.37 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,230.27 Median $1,584.89 Typical High $3,890.45 | Professional | 80 · Assistant surgeon | $1,230.27 | $1,584.89 | $3,890.45 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $870.96 Median $1,096.48 Typical High $2,691.53 | Professional | 81 · Minimal assistant surgeon | $870.96 | $1,096.48 | $2,691.53 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $870.96 Median $1,096.48 Typical High $2,691.53 | Professional | 82 · Assistant surgeon, no resident | $870.96 | $1,096.48 | $2,691.53 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $870.96 Median $1,096.48 Typical High $2,691.53 | Professional | AS · PA/NP assist | $870.96 | $1,096.48 | $2,691.53 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $4,677.35 Median $4,897.79 Typical High $11,748.98 | Professional | TC · Technical part | $4,677.35 | $4,897.79 | $11,748.98 |
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· 37th of 51
$6,310
MT $11,220PA $5,370
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.