How much rates vary
Facilitymedian $457 · 10th to 90th $251 to $1,660Professionalmedian $501 · 10th to 90th $363 to $759
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $602.56 | Professional | None | $331.13 | $398.11 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $457.09 | Professional | 54 · Surgery only | $302.00 | $302.00 | $457.09 |
BCBS Setting Facility Modifier None Typical Low $371.54 Median $588.84 Typical High $1,621.81 | Facility | None | $371.54 | $588.84 | $1,621.81 |
BCBS Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $851.14 | Professional | None | $398.11 | $512.86 | $851.14 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $416.87 Typical High $794.33 | Professional | 54 · Surgery only | $363.08 | $416.87 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $275.42 Typical High $389.05 | Facility | None | $245.47 | $275.42 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $630.96 | Professional | None | $338.84 | $446.68 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $602.56 Typical High $7,585.78 | Facility | None | $331.13 | $602.56 | $7,585.78 |
Moda Health Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $758.58 | Professional | None | $380.19 | $501.19 | $758.58 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $457.09 | Professional | 54 · Surgery only | $302.00 | $302.00 | $457.09 |
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 $363.08 Median $380.19 Typical High $676.08 | Facility | None | $363.08 | $380.19 | $676.08 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $794.33 | Professional | None | $380.19 | $467.74 | $794.33 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $467.74 | Professional | 54 · Surgery only | $309.03 | $309.03 | $467.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,041.74 | Facility | None | $1,023.29 | $1,445.44 | $2,041.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $758.58 | Professional | None | $398.11 | $501.19 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $380.19 Typical High $794.33 | Facility | None | $371.54 | $380.19 | $794.33 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $501.19 | Professional | None | $371.54 | $371.54 | $501.19 |
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 $288.40 Median $436.52 Typical High $660.69 | Professional | None | $288.40 | $436.52 | $660.69 |
9 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 |
|---|---|---|---|---|---|
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $48.98 Typical High $74.13 | Professional | 55 · Aftercare only | $39.81 | $48.98 | $74.13 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $501.19 Median $575.44 Typical High $1,047.13 | Professional | 63 · Small infant | $501.19 | $575.44 | $1,047.13 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $512.86 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $281.84 | $512.86 | $602.56 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $63.10 Median $117.49 Typical High $141.25 | Professional | 80 · Assistant surgeon | $63.10 | $117.49 | $141.25 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $66.07 Median $74.13 Typical High $141.25 | Professional | 81 · Minimal assistant surgeon | $66.07 | $74.13 | $141.25 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $66.07 Median $77.62 Typical High $128.82 | Professional | 82 · Assistant surgeon, no resident | $66.07 | $77.62 | $128.82 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $97.72 Typical High $120.23 | Professional | AS · PA/NP assist | $57.54 | $97.72 | $120.23 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $66.07 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $66.07 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $501.19 |
Where Idaho sits
The same service costs 5.5 times more in New York 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.
Physician feeFacility fee
NY $3,002MD $549
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.