How much rates vary
Facilitymedian $11,749 · 10th to 90th $7,762 to $17,783Professionalmedian $10,965 · 10th to 90th $7,762 to $17,783
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 $7,762.47 Median $7,762.47 Typical High $7,762.47 | Facility | None | $7,762.47 | $7,762.47 | $7,762.47 |
Aetna Setting Professional Modifier None (both parts) Typical Low $7,762.47 Median $7,762.47 Typical High $10,964.78 | Professional | None (both parts) | $7,762.47 | $7,762.47 | $10,964.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $15,848.93 Median $17,782.79 Typical High $17,782.79 | Facility | None | $15,848.93 | $17,782.79 | $17,782.79 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $10,715.19 Median $10,964.78 Typical High $17,782.79 | Professional | None (both parts) | $10,715.19 | $10,964.78 | $17,782.79 |
Cigna Setting Facility Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $11,748.98 | Facility | None | $11,748.98 | $11,748.98 | $11,748.98 |
Cigna Setting Professional Modifier None (both parts) Typical Low $8,511.38 Median $8,511.38 Typical High $11,748.98 | Professional | None (both parts) | $8,511.38 | $8,511.38 | $11,748.98 |
Medcost Setting Professional Modifier None Typical Low $10,715.19 Median $11,481.54 Typical High $11,481.54 | Professional | None | $10,715.19 | $11,481.54 | $11,481.54 |
Medcost Setting Facility Modifier None Typical Low $5,495.41 Median $8,511.38 Typical High $21,379.62 | Facility | None | $5,495.41 | $8,511.38 | $21,379.62 |
Medcost Setting Professional Modifier None (both parts) Typical Low $9,772.37 Median $12,302.69 Typical High $22,908.68 | Professional | None (both parts) | $9,772.37 | $12,302.69 | $22,908.68 |
United Setting Facility Modifier None Typical Low $7,585.78 Median $8,912.51 Typical High $22,908.68 | Facility | None | $7,585.78 | $8,912.51 | $22,908.68 |
United Setting Professional Modifier None (both parts) Typical Low $6,760.83 Median $8,709.64 Typical High $12,882.50 | Professional | None (both parts) | $6,760.83 | $8,709.64 | $12,882.50 |
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 $3,890.45 Median $3,890.45 Typical High $5,495.41 | Professional | 52 · Reduced service | $3,890.45 | $3,890.45 | $5,495.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,548.82 Median $1,548.82 Typical High $2,187.76 | Professional | 53 · Discontinued | $1,548.82 | $1,548.82 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,174.90 Median $1,174.90 Typical High $1,659.59 | Professional | 55 · Aftercare only | $1,174.90 | $1,174.90 | $1,659.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $776.25 Median $776.25 Typical High $1,096.48 | Professional | 56 · Pre-op care only | $776.25 | $776.25 | $1,096.48 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $5,011.87 Median $5,248.07 Typical High $12,302.69 | Professional | 26 · Professional part | $5,011.87 | $5,248.07 | $12,302.69 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $14,454.40 Median $18,620.87 Typical High $45,708.82 | Professional | 50 · Both sides | $14,454.40 | $18,620.87 | $45,708.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4,897.79 Median $6,165.95 Typical High $15,488.17 | Professional | 51 · Multiple procedures | $4,897.79 | $6,165.95 | $15,488.17 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,949.84 Median $2,454.71 Typical High $6,165.95 | Professional | 80 · Assistant surgeon | $1,949.84 | $2,454.71 | $6,165.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1,348.96 Median $1,737.80 Typical High $4,265.80 | Professional | 81 · Minimal assistant surgeon | $1,348.96 | $1,737.80 | $4,265.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,348.96 Median $1,737.80 Typical High $4,265.80 | Professional | 82 · Assistant surgeon, no resident | $1,348.96 | $1,737.80 | $4,265.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1,348.96 Median $1,737.80 Typical High $4,265.80 | Professional | AS · PA/NP assist | $1,348.96 | $1,737.80 | $4,265.80 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $7,413.10 Median $7,762.47 Typical High $18,197.01 | Professional | TC · Technical part | $7,413.10 | $7,762.47 | $18,197.01 |
Where South Carolina sits
The same service costs 2.6 times more in Montana 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· 30th of 51
$10,965
MT $21,878NJ $8,511
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.