How much rates vary
Facilitymedian $5,623 · 10th to 90th $4,571 to $10,233Professionalmedian $7,586 · 10th to 90th $4,571 to $10,233
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 $4,570.88 Median $4,570.88 Typical High $4,570.88 | Facility | None | $4,570.88 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier None (both parts) Typical Low $4,570.88 Median $4,570.88 Typical High $6,456.54 | Professional | None (both parts) | $4,570.88 | $4,570.88 | $6,456.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $9,332.54 Median $10,232.93 Typical High $10,232.93 | Facility | None | $9,332.54 | $10,232.93 | $10,232.93 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Professional | None (both parts) | $10,232.93 | $10,232.93 | $10,232.93 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Cigna Setting Professional Modifier None (both parts) Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None (both parts) | $4,786.30 | $4,786.30 | $5,623.41 |
Medcost Setting Facility Modifier None Typical Low $4,570.88 Median $6,165.95 Typical High $12,589.25 | Facility | None | $4,570.88 | $6,165.95 | $12,589.25 |
Medcost Setting Professional Modifier None (both parts) Typical Low $7,943.28 Median $7,943.28 Typical High $13,489.63 | Professional | None (both parts) | $7,943.28 | $7,943.28 | $13,489.63 |
United Setting Professional Modifier None (both parts) Typical Low $3,801.89 Median $5,011.87 Typical High $7,079.46 | Professional | None (both parts) | $3,801.89 | $5,011.87 | $7,079.46 |
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 $2,290.87 Median $2,290.87 Typical High $3,235.94 | Professional | 52 · Reduced service | $2,290.87 | $2,290.87 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $912.01 Typical High $1,288.25 | Professional | 53 · Discontinued | $912.01 | $912.01 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $676.08 Typical High $954.99 | Professional | 55 · Aftercare only | $676.08 | $676.08 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $457.09 Typical High $645.65 | Professional | 56 · Pre-op care only | $457.09 | $457.09 | $645.65 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $3,162.28 Median $3,162.28 Typical High $7,244.36 | Professional | 26 · Professional part | $3,162.28 | $3,162.28 | $7,244.36 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $12,022.64 Median $12,022.64 Typical High $26,915.35 | Professional | 50 · Both sides | $12,022.64 | $12,022.64 | $26,915.35 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3,981.07 Median $3,981.07 Typical High $8,912.51 | Professional | 51 · Multiple procedures | $3,981.07 | $3,981.07 | $8,912.51 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,584.89 Median $1,584.89 Typical High $3,548.13 | Professional | 80 · Assistant surgeon | $1,584.89 | $1,584.89 | $3,548.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1,122.02 Median $1,122.02 Typical High $2,511.89 | Professional | 81 · Minimal assistant surgeon | $1,122.02 | $1,122.02 | $2,511.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,122.02 Median $1,122.02 Typical High $2,511.89 | Professional | 82 · Assistant surgeon, no resident | $1,122.02 | $1,122.02 | $2,511.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1,122.02 Median $1,122.02 Typical High $2,511.89 | Professional | AS · PA/NP assist | $1,122.02 | $1,122.02 | $2,511.89 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $4,786.30 Median $4,786.30 Typical High $10,715.19 | Professional | TC · Technical part | $4,786.30 | $4,786.30 | $10,715.19 |
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· 16th of 51
$7,079
MT $10,715NY $4,169
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.