How much rates vary
Facilitymedian $4,677 · 10th to 90th $2,089 to $9,333Professionalmedian $3,981 · 10th to 90th $2,884 to $4,898
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $4,677.35 Typical High $4,677.35 | Professional | None | $2,884.03 | $4,677.35 | $4,677.35 |
BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $8,709.64 Typical High $10,232.93 | Facility | None | $6,309.57 | $8,709.64 | $10,232.93 |
BCBS Setting Professional Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $4,570.88 | Professional | None | $3,548.13 | $4,168.69 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $4,168.69 Median $4,677.35 Typical High $6,456.54 | Facility | None | $4,168.69 | $4,677.35 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $3,162.28 Typical High $3,630.78 | Professional | None | $2,754.23 | $3,162.28 | $3,630.78 |
Moda Health Setting Facility Modifier None Typical Low $1,862.09 Median $4,466.84 Typical High $6,760.83 | Facility | None | $1,862.09 | $4,466.84 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $2,884.03 Median $4,677.35 Typical High $5,495.41 | Professional | None | $2,884.03 | $4,677.35 | $5,495.41 |
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 $3,162.28 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,162.28 | $3,890.45 | $3,890.45 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $5,011.87 | Professional | None | $3,890.45 | $3,890.45 | $5,011.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,165.95 Median $8,128.31 Typical High $10,232.93 | Facility | None | $6,165.95 | $8,128.31 | $10,232.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,890.45 Median $4,570.88 Typical High $5,495.41 | Professional | None | $3,890.45 | $4,570.88 | $5,495.41 |
Select Health Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,949.84 | Facility | None | $1,862.09 | $1,862.09 | $1,949.84 |
Select Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $4,365.16 | Professional | None | $1,862.09 | $2,290.87 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $2,454.71 Median $3,388.44 Typical High $5,011.87 | Professional | None | $2,454.71 | $3,388.44 | $5,011.87 |
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 $1,445.44 Median $2,344.23 Typical High $2,344.23 | Professional | 52 · Reduced service | $1,445.44 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $933.25 Typical High $933.25 | Professional | 53 · Discontinued | $588.84 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $3,548.13 Typical High $3,548.13 | Professional | 54 · Surgery only | $2,187.76 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $707.95 Typical High $707.95 | Professional | 55 · Aftercare only | $436.52 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $467.74 Typical High $467.74 | Professional | 56 · Pre-op care only | $288.40 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $3,311.31 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $2,041.74 | $3,311.31 | $3,311.31 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $3,235.94 Median $3,715.35 Typical High $3,890.45 | Professional | 54 · Surgery only | $3,235.94 | $3,715.35 | $3,890.45 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $407.38 Typical High $436.52 | Professional | 55 · Aftercare only | $354.81 | $407.38 | $436.52 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,238.72 Median $2,570.40 Typical High $2,691.53 | Professional | 62 · Two surgeons | $2,238.72 | $2,570.40 | $2,691.53 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $4,265.80 Median $4,897.79 Typical High $5,248.07 | Professional | 63 · Small infant | $4,265.80 | $4,897.79 | $5,248.07 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,884.03 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,884.03 | $3,019.95 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $575.44 Median $660.69 Typical High $691.83 | Professional | 80 · Assistant surgeon | $575.44 | $660.69 | $691.83 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $575.44 Median $660.69 Typical High $691.83 | Professional | 81 · Minimal assistant surgeon | $575.44 | $660.69 | $691.83 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $575.44 Median $660.69 Typical High $691.83 | Professional | 82 · Assistant surgeon, no resident | $575.44 | $660.69 | $691.83 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $489.78 Median $562.34 Typical High $588.84 | Professional | AS · PA/NP assist | $489.78 | $562.34 | $588.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,445.44 Median $2,344.23 Typical High $2,344.23 | Professional | 52 · Reduced service | $1,445.44 | $2,344.23 | $2,344.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $933.25 Typical High $933.25 | Professional | 53 · Discontinued | $588.84 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $3,548.13 Typical High $3,548.13 | Professional | 54 · Surgery only | $2,187.76 | $3,548.13 | $3,548.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $707.95 Typical High $707.95 | Professional | 55 · Aftercare only | $436.52 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $467.74 Typical High $467.74 | Professional | 56 · Pre-op care only | $288.40 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $3,311.31 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $2,041.74 | $3,311.31 | $3,311.31 |
Where Idaho sits
The same service costs 21.9 times more in Alaska than in Texas. 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· 10th of 51
$3,981
AK $9,333TX $427
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.