How much rates vary
Facilitymedian $4,677 · 10th to 90th $3,548 to $9,120Professionalmedian $5,129 · 10th to 90th $3,981 to $9,120
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 $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier None (both parts) Typical Low $3,981.07 Median $3,981.07 Typical High $5,370.32 | Professional | None (both parts) | $3,981.07 | $3,981.07 | $5,370.32 |
BCBS South Carolina Setting Facility Modifier None Typical Low $8,128.31 Median $9,120.11 Typical High $9,120.11 | Facility | None | $8,128.31 | $9,120.11 | $9,120.11 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $5,128.61 Median $7,413.10 Typical High $9,120.11 | Professional | None (both parts) | $5,128.61 | $7,413.10 | $9,120.11 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Cigna Setting Professional Modifier None (both parts) Typical Low $3,467.37 Median $3,467.37 Typical High $5,370.32 | Professional | None (both parts) | $3,467.37 | $3,467.37 | $5,370.32 |
Medcost Setting Professional Modifier None Typical Low $4,265.80 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,265.80 | $4,677.35 | $4,677.35 |
Medcost Setting Facility Modifier None Typical Low $2,290.87 Median $4,365.16 Typical High $10,964.78 | Facility | None | $2,290.87 | $4,365.16 | $10,964.78 |
Medcost Setting Professional Modifier None (both parts) Typical Low $5,011.87 Median $6,456.54 Typical High $12,022.64 | Professional | None (both parts) | $5,011.87 | $6,456.54 | $12,022.64 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $9,549.93 | Facility | None | $2,884.03 | $3,548.13 | $9,549.93 |
United Setting Professional Modifier None (both parts) Typical Low $2,951.21 Median $4,466.84 Typical High $5,370.32 | Professional | None (both parts) | $2,951.21 | $4,466.84 | $5,370.32 |
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 $1,995.26 Median $1,995.26 Typical High $2,691.53 | Professional | 52 · Reduced service | $1,995.26 | $1,995.26 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $1,071.52 | Professional | 53 · Discontinued | $794.33 | $794.33 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $812.83 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $398.11 Typical High $537.03 | Professional | 56 · Pre-op care only | $398.11 | $398.11 | $537.03 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $2,570.40 Median $2,691.53 Typical High $6,309.57 | Professional | 26 · Professional part | $2,570.40 | $2,691.53 | $6,309.57 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $7,585.78 Median $9,549.93 Typical High $23,988.33 | Professional | 50 · Both sides | $7,585.78 | $9,549.93 | $23,988.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2,511.89 Median $3,235.94 Typical High $7,943.28 | Professional | 51 · Multiple procedures | $2,511.89 | $3,235.94 | $7,943.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,000.00 Median $1,288.25 Typical High $3,162.28 | Professional | 80 · Assistant surgeon | $1,000.00 | $1,288.25 | $3,162.28 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $707.95 Median $891.25 Typical High $2,238.72 | Professional | 81 · Minimal assistant surgeon | $707.95 | $891.25 | $2,238.72 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $707.95 Median $891.25 Typical High $2,238.72 | Professional | 82 · Assistant surgeon, no resident | $707.95 | $891.25 | $2,238.72 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $707.95 Median $891.25 Typical High $2,238.72 | Professional | AS · PA/NP assist | $707.95 | $891.25 | $2,238.72 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $3,801.89 Median $4,073.80 Typical High $9,549.93 | Professional | TC · Technical part | $3,801.89 | $4,073.80 | $9,549.93 |
Where South Carolina sits
The same service costs 2.3 times more in Arkansas than in Vermont. 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· 22nd of 51
$5,129
AR $8,128VT $3,467
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.