How much rates vary
Facilitymedian $12,589 · 10th to 90th $8,128 to $18,197Professionalmedian $11,482 · 10th to 90th $8,128 to $18,197
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 $8,128.31 Median $8,128.31 Typical High $8,128.31 | Facility | None | $8,128.31 | $8,128.31 | $8,128.31 |
Aetna Setting Professional Modifier None (both parts) Typical Low $8,128.31 Median $8,128.31 Typical High $11,481.54 | Professional | None (both parts) | $8,128.31 | $8,128.31 | $11,481.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $16,595.87 Median $18,197.01 Typical High $18,197.01 | Facility | None | $16,595.87 | $18,197.01 | $18,197.01 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $11,220.18 Median $11,481.54 Typical High $18,197.01 | Professional | None (both parts) | $11,220.18 | $11,481.54 | $18,197.01 |
Cigna Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $12,589.25 | Facility | None | $12,589.25 | $12,589.25 | $12,589.25 |
Cigna Setting Professional Modifier None (both parts) Typical Low $9,120.11 Median $9,120.11 Typical High $12,589.25 | Professional | None (both parts) | $9,120.11 | $9,120.11 | $12,589.25 |
Medcost Setting Professional Modifier None Typical Low $11,481.54 Median $11,481.54 Typical High $11,481.54 | Professional | None | $11,481.54 | $11,481.54 | $11,481.54 |
Medcost Setting Facility Modifier None Typical Low $5,623.41 Median $8,912.51 Typical High $22,387.21 | Facility | None | $5,623.41 | $8,912.51 | $22,387.21 |
Medcost Setting Professional Modifier None (both parts) Typical Low $10,232.93 Median $12,882.50 Typical High $23,988.33 | Professional | None (both parts) | $10,232.93 | $12,882.50 | $23,988.33 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $9,332.54 Typical High $23,988.33 | Facility | None | $7,943.28 | $9,332.54 | $23,988.33 |
United Setting Professional Modifier None (both parts) Typical Low $7,079.46 Median $8,912.51 Typical High $13,182.57 | Professional | None (both parts) | $7,079.46 | $8,912.51 | $13,182.57 |
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 $4,073.80 Median $4,073.80 Typical High $5,623.41 | Professional | 52 · Reduced service | $4,073.80 | $4,073.80 | $5,623.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,621.81 Median $1,621.81 Typical High $2,290.87 | Professional | 53 · Discontinued | $1,621.81 | $1,621.81 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,202.26 Median $1,202.26 Typical High $1,698.24 | Professional | 55 · Aftercare only | $1,202.26 | $1,202.26 | $1,698.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $812.83 Median $812.83 Typical High $1,148.15 | Professional | 56 · Pre-op care only | $812.83 | $812.83 | $1,148.15 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $5,128.61 Median $5,370.32 Typical High $12,882.50 | Professional | 26 · Professional part | $5,128.61 | $5,370.32 | $12,882.50 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $15,135.61 Median $19,498.45 Typical High $47,863.01 | Professional | 50 · Both sides | $15,135.61 | $19,498.45 | $47,863.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5,128.61 Median $6,456.54 Typical High $15,848.93 | Professional | 51 · Multiple procedures | $5,128.61 | $6,456.54 | $15,848.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2,041.74 Median $2,570.40 Typical High $6,456.54 | Professional | 80 · Assistant surgeon | $2,041.74 | $2,570.40 | $6,456.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1,412.54 Median $1,819.70 Typical High $4,466.84 | Professional | 81 · Minimal assistant surgeon | $1,412.54 | $1,819.70 | $4,466.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,412.54 Median $1,819.70 Typical High $4,466.84 | Professional | 82 · Assistant surgeon, no resident | $1,412.54 | $1,819.70 | $4,466.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1,412.54 Median $1,819.70 Typical High $4,466.84 | Professional | AS · PA/NP assist | $1,412.54 | $1,819.70 | $4,466.84 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $7,762.47 Median $8,128.31 Typical High $19,054.61 | Professional | TC · Technical part | $7,762.47 | $8,128.31 | $19,054.61 |
Where South Carolina sits
The same service costs 2.5 times more in Montana than in Florida. 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· 28th of 51
$11,482
MT $22,387FL $9,120
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.