How much rates vary
Facilitymedian $195 · 10th to 90th $123 to $282Professionalmedian $155 · 10th to 90th $123 to $282
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 $123.03 Median $123.03 Typical High $288.40 | Facility | None | $123.03 | $123.03 | $288.40 |
Aetna Setting Professional Modifier None (both parts) Typical Low $123.03 Median $123.03 Typical High $173.78 | Professional | None (both parts) | $123.03 | $123.03 | $173.78 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None (both parts) | $239.88 | $239.88 | $239.88 |
BCBS South Carolina Setting Facility Modifier None Typical Low $251.19 Median $281.84 Typical High $281.84 | Facility | None | $251.19 | $281.84 | $281.84 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $134.90 Median $223.87 Typical High $281.84 | Professional | None (both parts) | $134.90 | $223.87 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None (both parts) Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | None (both parts) | $165.96 | $165.96 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $158.49 | Professional | None | $131.83 | $131.83 | $158.49 |
Medcost Setting Facility Modifier None Typical Low $75.86 Median $134.90 Typical High $338.84 | Facility | None | $75.86 | $134.90 | $338.84 |
Medcost Setting Professional Modifier None (both parts) Typical Low $154.88 Median $199.53 Typical High $371.54 | Professional | None (both parts) | $154.88 | $199.53 | $371.54 |
United Setting Professional Modifier None (both parts) Typical Low $97.72 Median $138.04 Typical High $177.83 | Professional | None (both parts) | $97.72 | $138.04 | $177.83 |
10 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 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $26.30 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $17.38 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $79.43 Median $83.18 Typical High $194.98 | Professional | 26 · Professional part | $79.43 | $83.18 | $194.98 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $234.42 Median $295.12 Typical High $741.31 | Professional | 50 · Both sides | $234.42 | $295.12 | $741.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $100.00 Typical High $245.47 | Professional | 51 · Multiple procedures | $77.62 | $100.00 | $245.47 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.90 Median $39.81 Typical High $97.72 | Professional | 80 · Assistant surgeon | $30.90 | $39.81 | $97.72 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.88 Median $27.54 Typical High $69.18 | Professional | 81 · Minimal assistant surgeon | $21.88 | $27.54 | $69.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.88 Median $27.54 Typical High $69.18 | Professional | 82 · Assistant surgeon, no resident | $21.88 | $27.54 | $69.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $21.88 Median $27.54 Typical High $69.18 | Professional | AS · PA/NP assist | $21.88 | $27.54 | $69.18 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $117.49 Median $125.89 Typical High $295.12 | Professional | TC · Technical part | $117.49 | $125.89 | $295.12 |
Where South Carolina sits
The same service costs 2.6 times more in Montana than in New York. 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· 42nd of 51
$158
MT $275NY $107
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.