How much rates vary
Facilitymedian $372 · 10th to 90th $195 to $447Professionalmedian $275 · 10th to 90th $195 to $447
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 $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None (both parts) Typical Low $194.98 Median $194.98 Typical High $275.42 | Professional | None (both parts) | $194.98 | $194.98 | $275.42 |
BCBS South Carolina Setting Facility Modifier None Typical Low $407.38 Median $446.68 Typical High $446.68 | Facility | None | $407.38 | $446.68 | $446.68 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $275.42 Median $446.68 Typical High $446.68 | Professional | None (both parts) | $275.42 | $446.68 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None (both parts) | $316.23 | $316.23 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | None | $208.93 | $208.93 | $251.19 |
Medcost Setting Facility Modifier None Typical Low $134.90 Median $213.80 Typical High $537.03 | Facility | None | $134.90 | $213.80 | $537.03 |
Medcost Setting Professional Modifier None (both parts) Typical Low $245.47 Median $316.23 Typical High $588.84 | Professional | None (both parts) | $245.47 | $316.23 | $588.84 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None (both parts) Typical Low $169.82 Median $218.78 Typical High $316.23 | Professional | None (both parts) | $169.82 | $218.78 | $316.23 |
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 $97.72 Median $97.72 Typical High $138.04 | Professional | 52 · Reduced service | $97.72 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $54.95 | Professional | 53 · Discontinued | $38.90 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $41.69 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $27.54 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $125.89 Median $131.83 Typical High $309.03 | Professional | 26 · Professional part | $125.89 | $131.83 | $309.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $467.74 Typical High $1,174.90 | Professional | 50 · Both sides | $371.54 | $467.74 | $1,174.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $123.03 Median $158.49 Typical High $389.05 | Professional | 51 · Multiple procedures | $123.03 | $158.49 | $389.05 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $63.10 Typical High $154.88 | Professional | 80 · Assistant surgeon | $48.98 | $63.10 | $154.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $34.67 Median $43.65 Typical High $109.65 | Professional | 81 · Minimal assistant surgeon | $34.67 | $43.65 | $109.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $34.67 Median $43.65 Typical High $109.65 | Professional | 82 · Assistant surgeon, no resident | $34.67 | $43.65 | $109.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $43.65 Typical High $109.65 | Professional | AS · PA/NP assist | $34.67 | $43.65 | $109.65 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $190.55 Median $199.53 Typical High $467.74 | Professional | TC · Technical part | $190.55 | $199.53 | $467.74 |
Where South Carolina sits
The same service costs 3.4 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
$275
MT $589NY $174
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.