How much rates vary
Facilitymedian $1,479 · 10th to 90th $1,202 to $2,754Professionalmedian $1,778 · 10th to 90th $1,202 to $2,754
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 $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,202.26 Median $1,202.26 Typical High $1,659.59 | Professional | None (both parts) | $1,202.26 | $1,202.26 | $1,659.59 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,511.89 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,511.89 | $2,754.23 | $2,754.23 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None (both parts) | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,258.93 Median $1,258.93 Typical High $1,621.81 | Professional | None (both parts) | $1,258.93 | $1,258.93 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $1,348.96 Typical High $3,311.31 | Facility | None | $758.58 | $1,348.96 | $3,311.31 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,513.56 Median $1,949.84 Typical High $3,630.78 | Professional | None (both parts) | $1,513.56 | $1,949.84 | $3,630.78 |
United Setting Professional Modifier None (both parts) Typical Low $977.24 Median $1,348.96 Typical High $1,778.28 | Professional | None (both parts) | $977.24 | $1,348.96 | $1,778.28 |
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 $602.56 Median $602.56 Typical High $831.76 | Professional | 52 · Reduced service | $602.56 | $602.56 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $331.13 | Professional | 53 · Discontinued | $245.47 | $245.47 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $251.19 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $165.96 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $776.25 Median $812.83 Typical High $1,905.46 | Professional | 26 · Professional part | $776.25 | $812.83 | $1,905.46 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $2,884.03 Typical High $7,244.36 | Professional | 50 · Both sides | $2,290.87 | $2,884.03 | $7,244.36 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $758.58 Median $977.24 Typical High $2,398.83 | Professional | 51 · Multiple procedures | $758.58 | $977.24 | $2,398.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $389.05 Typical High $954.99 | Professional | 80 · Assistant surgeon | $302.00 | $389.05 | $954.99 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $213.80 Median $269.15 Typical High $676.08 | Professional | 81 · Minimal assistant surgeon | $213.80 | $269.15 | $676.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $213.80 Median $269.15 Typical High $676.08 | Professional | 82 · Assistant surgeon, no resident | $213.80 | $269.15 | $676.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $269.15 Typical High $676.08 | Professional | AS · PA/NP assist | $213.80 | $269.15 | $676.08 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,174.90 Median $1,230.27 Typical High $2,884.03 | Professional | TC · Technical part | $1,174.90 | $1,230.27 | $2,884.03 |
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· 19th of 51
$1,778
MT $2,754NY $1,072
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.