How much rates vary
Facilitymedian $363 · 10th to 90th $123 to $2,630Professionalmedian $145 · 10th to 90th $112 to $182
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $144.54 | Professional | None | $123.03 | $134.90 | $144.54 |
BCBS Setting Facility Modifier None Typical Low $363.08 Median $1,380.38 Typical High $6,456.54 | Facility | None | $363.08 | $1,380.38 | $6,456.54 |
BCBS Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $208.93 | Professional | None | $134.90 | $151.36 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $151.36 | Professional | None | $107.15 | $131.83 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $93.33 Median $144.54 Typical High $5,495.41 | Facility | None | $93.33 | $144.54 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $181.97 | Professional | None | $123.03 | $144.54 | $181.97 |
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 $117.49 Median $123.03 Typical High $165.96 | Facility | None | $117.49 | $123.03 | $165.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $194.98 | Professional | None | $123.03 | $147.91 | $194.98 |
Regence BlueShield Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $181.97 | Professional | None | $134.90 | $147.91 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $2,630.27 | Facility | None | $93.33 | $95.50 | $2,630.27 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $123.03 | Professional | None | $93.33 | $93.33 | $123.03 |
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 $87.10 Median $120.23 Typical High $158.49 | Professional | None | $87.10 | $120.23 | $158.49 |
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 54 · Surgery only Typical Low $120.23 Median $141.25 Typical High $181.97 | Professional | 54 · Surgery only | $120.23 | $141.25 | $181.97 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.14 Typical High $21.38 | Professional | 55 · Aftercare only | $13.49 | $15.14 | $21.38 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $83.18 Median $97.72 Typical High $117.49 | Professional | 62 · Two surgeons | $83.18 | $97.72 | $117.49 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $165.96 Median $194.98 Typical High $223.87 | Professional | 63 · Small infant | $165.96 | $194.98 | $223.87 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $107.15 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $93.33 | $107.15 | $120.23 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $112.20 | Professional | 54 · Surgery only | $104.71 | $104.71 | $112.20 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $16.22 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $16.22 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $93.33 Median $93.33 Typical High $100.00 | Professional | 62 · Two surgeons | $93.33 | $93.33 | $100.00 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $112.20 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $112.20 | $112.20 | $120.23 |
Where Idaho sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 11th of 51
$145
AK $355NJ $87.10
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.