How much rates vary
Facilitymedian $9,120 · 10th to 90th $5,754 to $13,183Professionalmedian $7,413 · 10th to 90th $5,754 to $13,183
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 $5,754.40 Median $5,754.40 Typical High $5,754.40 | Facility | None | $5,754.40 | $5,754.40 | $5,754.40 |
Aetna Setting Professional Modifier None (both parts) Typical Low $5,754.40 Median $5,754.40 Typical High $8,128.31 | Professional | None (both parts) | $5,754.40 | $5,754.40 | $8,128.31 |
BCBS South Carolina Setting Facility Modifier None Typical Low $11,748.98 Median $13,182.57 Typical High $13,182.57 | Facility | None | $11,748.98 | $13,182.57 | $13,182.57 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $7,413.10 Median $10,715.19 Typical High $13,182.57 | Professional | None (both parts) | $7,413.10 | $10,715.19 | $13,182.57 |
Cigna Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $6,606.93 Median $6,606.93 Typical High $9,120.11 | Professional | None (both parts) | $6,606.93 | $6,606.93 | $9,120.11 |
Medcost Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $7,762.47 | Professional | None | $6,760.83 | $6,760.83 | $7,762.47 |
Medcost Setting Facility Modifier None Typical Low $3,981.07 Median $6,309.57 Typical High $15,848.93 | Facility | None | $3,981.07 | $6,309.57 | $15,848.93 |
Medcost Setting Professional Modifier None (both parts) Typical Low $7,244.36 Median $9,120.11 Typical High $16,982.44 | Professional | None (both parts) | $7,244.36 | $9,120.11 | $16,982.44 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $6,165.95 Typical High $16,595.87 | Facility | None | $5,128.61 | $6,165.95 | $16,595.87 |
United Setting Professional Modifier None (both parts) Typical Low $5,011.87 Median $6,456.54 Typical High $9,120.11 | Professional | None (both parts) | $5,011.87 | $6,456.54 | $9,120.11 |
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 $2,884.03 Median $2,884.03 Typical High $4,073.80 | Professional | 52 · Reduced service | $2,884.03 | $2,884.03 | $4,073.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,148.15 Median $1,148.15 Typical High $1,621.81 | Professional | 53 · Discontinued | $1,148.15 | $1,148.15 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $870.96 Median $870.96 Typical High $1,230.27 | Professional | 55 · Aftercare only | $870.96 | $870.96 | $1,230.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $575.44 Median $575.44 Typical High $812.83 | Professional | 56 · Pre-op care only | $575.44 | $575.44 | $812.83 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $3,715.35 Median $3,890.45 Typical High $9,120.11 | Professional | 26 · Professional part | $3,715.35 | $3,890.45 | $9,120.11 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $10,964.78 Median $13,803.84 Typical High $33,884.42 | Professional | 50 · Both sides | $10,964.78 | $13,803.84 | $33,884.42 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3,630.78 Median $4,570.88 Typical High $11,481.54 | Professional | 51 · Multiple procedures | $3,630.78 | $4,570.88 | $11,481.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,445.44 Median $1,862.09 Typical High $4,570.88 | Professional | 80 · Assistant surgeon | $1,445.44 | $1,862.09 | $4,570.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1,023.29 Median $1,288.25 Typical High $3,162.28 | Professional | 81 · Minimal assistant surgeon | $1,023.29 | $1,288.25 | $3,162.28 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,023.29 Median $1,288.25 Typical High $3,162.28 | Professional | 82 · Assistant surgeon, no resident | $1,023.29 | $1,288.25 | $3,162.28 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1,023.29 Median $1,288.25 Typical High $3,162.28 | Professional | AS · PA/NP assist | $1,023.29 | $1,288.25 | $3,162.28 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $5,495.41 Median $5,754.40 Typical High $13,803.84 | Professional | TC · Technical part | $5,495.41 | $5,754.40 | $13,803.84 |
Where South Carolina sits
The same service costs 2.5 times more in Montana than in Delaware. 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
$7,413
MT $16,596DE $6,607
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.