How much rates vary
Facilitymedian $182 · 10th to 90th $129 to $1,047Professionalmedian $186 · 10th to 90th $132 to $347
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $281.84 | Professional | None | $120.23 | $147.91 | $281.84 |
BCBS Setting Facility Modifier None Typical Low $112.20 Median $158.49 Typical High $1,047.13 | Facility | None | $112.20 | $158.49 | $1,047.13 |
BCBS Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $371.54 | Professional | None | $144.54 | $234.42 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $144.54 Typical High $194.98 | Facility | None | $128.82 | $144.54 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $288.40 | Professional | None | $134.90 | $177.83 | $288.40 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $165.96 Typical High $4,466.84 | Facility | None | $104.71 | $165.96 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $346.74 | Professional | None | $125.89 | $186.21 | $346.74 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $123.03 Median $131.83 Typical High $295.12 | Facility | None | $123.03 | $131.83 | $295.12 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $346.74 | Professional | None | $131.83 | $204.17 | $346.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $676.08 Median $954.99 Typical High $1,318.26 | Facility | None | $676.08 | $954.99 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $346.74 | Professional | None | $144.54 | $190.55 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $371.54 | Facility | None | $165.96 | $165.96 | $371.54 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $281.84 | Professional | None | $107.15 | $165.96 | $281.84 |
21 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 $74.13 Median $87.10 Typical High $138.04 | Professional | 52 · Reduced service | $74.13 | $87.10 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $34.67 Typical High $56.23 | Professional | 53 · Discontinued | $29.51 | $34.67 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $131.83 Typical High $208.93 | Professional | 54 · Surgery only | $109.65 | $131.83 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.30 Typical High $41.69 | Professional | 55 · Aftercare only | $21.88 | $26.30 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $17.38 Typical High $28.18 | Professional | 56 · Pre-op care only | $14.79 | $17.38 | $28.18 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $147.91 Typical High $346.74 | Professional | 54 · Surgery only | $125.89 | $147.91 | $346.74 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $27.54 Typical High $38.90 | Professional | 55 · Aftercare only | $15.85 | $27.54 | $38.90 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $173.78 Median $204.17 Typical High $446.68 | Professional | 63 · Small infant | $173.78 | $204.17 | $446.68 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $120.23 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $97.72 | $120.23 | $229.09 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.39 Median $26.30 Typical High $52.48 | Professional | 80 · Assistant surgeon | $22.39 | $26.30 | $52.48 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $22.39 Median $26.30 Typical High $57.54 | Professional | 81 · Minimal assistant surgeon | $22.39 | $26.30 | $57.54 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $22.39 Median $26.30 Typical High $61.66 | Professional | 82 · Assistant surgeon, no resident | $22.39 | $26.30 | $61.66 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $19.95 Median $22.39 Typical High $47.86 | Professional | AS · PA/NP assist | $19.95 | $22.39 | $47.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $74.13 Typical High $138.04 | Professional | 52 · Reduced service | $74.13 | $74.13 | $138.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $56.23 | Professional | 53 · Discontinued | $29.51 | $29.51 | $56.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $208.93 | Professional | 54 · Surgery only | $109.65 | $109.65 | $208.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $41.69 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $41.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $28.18 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $28.18 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $213.80 | Professional | 54 · Surgery only | $114.82 | $114.82 | $213.80 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $30.90 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $30.90 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $123.03 | $123.03 | $229.09 |
Where Idaho sits
The same service costs 3.3 times more in Alaska than in Maryland. 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.
Idaho· 17th of 51
$186
AK $398MD $120
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.