How much rates vary
Facilitymedian $661 · 10th to 90th $339 to $759Professionalmedian $759 · 10th to 90th $339 to $759
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 $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier None (both parts) Typical Low $338.84 Median $338.84 Typical High $478.63 | Professional | None (both parts) | $338.84 | $338.84 | $478.63 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $758.58 Typical High $758.58 | Facility | None | $691.83 | $758.58 | $758.58 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $758.58 Median $758.58 Typical High $812.83 | Professional | None (both parts) | $758.58 | $758.58 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None (both parts) Typical Low $562.34 Median $562.34 Typical High $660.69 | Professional | None (both parts) | $562.34 | $562.34 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $446.68 | Professional | None | $371.54 | $371.54 | $446.68 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $371.54 Typical High $933.25 | Facility | None | $239.88 | $371.54 | $933.25 |
Medcost Setting Professional Modifier None (both parts) Typical Low $416.87 Median $537.03 Typical High $1,000.00 | Professional | None (both parts) | $416.87 | $537.03 | $1,000.00 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None (both parts) Typical Low $295.12 Median $371.54 Typical High $562.34 | Professional | None (both parts) | $295.12 | $371.54 | $562.34 |
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 $165.96 Median $165.96 Typical High $239.88 | Professional | 52 · Reduced service | $165.96 | $165.96 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $95.50 | Professional | 53 · Discontinued | $67.61 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $70.79 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $47.86 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $47.86 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $213.80 Median $223.87 Typical High $524.81 | Professional | 26 · Professional part | $213.80 | $223.87 | $524.81 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $812.83 Typical High $1,995.26 | Professional | 50 · Both sides | $630.96 | $812.83 | $1,995.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $269.15 Typical High $660.69 | Professional | 51 · Multiple procedures | $208.93 | $269.15 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $107.15 Typical High $263.03 | Professional | 80 · Assistant surgeon | $83.18 | $107.15 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $58.88 Median $75.86 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $58.88 | $75.86 | $186.21 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $58.88 Median $75.86 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $58.88 | $75.86 | $186.21 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $75.86 Typical High $186.21 | Professional | AS · PA/NP assist | $58.88 | $75.86 | $186.21 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $323.59 Median $338.84 Typical High $794.33 | Professional | TC · Technical part | $323.59 | $338.84 | $794.33 |
Where South Carolina sits
The same service costs 2.5 times more in Montana than in Washington, DC. 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· 9th of 51
$759
MT $1,047DC $417
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.