How much rates vary
Facilitymedian $30,200 · 10th to 90th $17,378 to $39,811Professionalmedian $24,547 · 10th to 90th $17,378 to $39,811
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 $17,378.01 Median $17,378.01 Typical High $17,378.01 | Facility | None | $17,378.01 | $17,378.01 | $17,378.01 |
Aetna Setting Professional Modifier None (both parts) Typical Low $17,378.01 Median $17,378.01 Typical High $24,547.09 | Professional | None (both parts) | $17,378.01 | $17,378.01 | $24,547.09 |
BCBS South Carolina Setting Facility Modifier None Typical Low $36,307.81 Median $39,810.72 Typical High $39,810.72 | Facility | None | $36,307.81 | $39,810.72 | $39,810.72 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $24,547.09 Median $24,547.09 Typical High $39,810.72 | Professional | None (both parts) | $24,547.09 | $24,547.09 | $39,810.72 |
Cigna Setting Facility Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $30,199.52 | Facility | None | $30,199.52 | $30,199.52 | $30,199.52 |
Cigna Setting Professional Modifier None (both parts) Typical Low $22,387.21 Median $22,387.21 Typical High $30,199.52 | Professional | None (both parts) | $22,387.21 | $22,387.21 | $30,199.52 |
Medcost Setting Professional Modifier None Typical Low $24,547.09 Median $24,547.09 Typical High $25,118.86 | Professional | None | $24,547.09 | $24,547.09 | $25,118.86 |
Medcost Setting Facility Modifier None Typical Low $12,589.25 Median $19,952.62 Typical High $47,863.01 | Facility | None | $12,589.25 | $19,952.62 | $47,863.01 |
Medcost Setting Professional Modifier None (both parts) Typical Low $21,877.62 Median $28,183.83 Typical High $52,480.75 | Professional | None (both parts) | $21,877.62 | $28,183.83 | $52,480.75 |
United Setting Facility Modifier None Typical Low $53,703.18 Median $53,703.18 Typical High $53,703.18 | Facility | None | $53,703.18 | $53,703.18 | $53,703.18 |
United Setting Professional Modifier None (both parts) Typical Low $15,488.17 Median $19,498.45 Typical High $29,512.09 | Professional | None (both parts) | $15,488.17 | $19,498.45 | $29,512.09 |
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 $8,709.64 Median $8,709.64 Typical High $12,302.69 | Professional | 52 · Reduced service | $8,709.64 | $8,709.64 | $12,302.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,548.13 Median $3,548.13 Typical High $5,011.87 | Professional | 53 · Discontinued | $3,548.13 | $3,548.13 | $5,011.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,630.27 Median $2,630.27 Typical High $3,715.35 | Professional | 55 · Aftercare only | $2,630.27 | $2,630.27 | $3,715.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,737.80 Median $1,737.80 Typical High $2,454.71 | Professional | 56 · Pre-op care only | $1,737.80 | $1,737.80 | $2,454.71 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $11,220.18 Median $11,748.98 Typical High $27,542.29 | Professional | 26 · Professional part | $11,220.18 | $11,748.98 | $27,542.29 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $33,113.11 Median $41,686.94 Typical High $104,712.85 | Professional | 50 · Both sides | $33,113.11 | $41,686.94 | $104,712.85 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $10,964.78 Median $14,125.38 Typical High $34,673.69 | Professional | 51 · Multiple procedures | $10,964.78 | $14,125.38 | $34,673.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4,365.16 Median $5,623.41 Typical High $13,803.84 | Professional | 80 · Assistant surgeon | $4,365.16 | $5,623.41 | $13,803.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3,090.30 Median $3,890.45 Typical High $9,772.37 | Professional | 81 · Minimal assistant surgeon | $3,090.30 | $3,890.45 | $9,772.37 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3,090.30 Median $3,890.45 Typical High $9,772.37 | Professional | 82 · Assistant surgeon, no resident | $3,090.30 | $3,890.45 | $9,772.37 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3,090.30 Median $3,890.45 Typical High $9,772.37 | Professional | AS · PA/NP assist | $3,090.30 | $3,890.45 | $9,772.37 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $16,982.44 Median $17,782.79 Typical High $41,686.94 | Professional | TC · Technical part | $16,982.44 | $17,782.79 | $41,686.94 |
Where South Carolina sits
The same service costs 2.1 times more in Hawaii 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· 33rd of 51
$24,547
HI $47,863NJ $22,387
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.