How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,738 to $15,136Professionalmedian $1,778 · 10th to 90th $1,259 to $2,188
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 $4,786.30 Typical High $6,918.31 | Facility | None | $4,466.84 | $4,786.30 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,288.25 | $2,041.74 | $2,041.74 |
BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $8,511.38 Typical High $17,782.79 | Facility | None | $3,630.78 | $8,511.38 | $17,782.79 |
BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,862.09 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,011.87 | Facility | None | $3,311.31 | $3,715.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,380.38 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,041.74 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,041.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $2,398.83 | Professional | None | $1,288.25 | $2,041.74 | $2,398.83 |
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 $1,412.54 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,412.54 | $1,737.80 | $1,737.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,737.80 | $1,737.80 | $2,187.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,819.70 | $1,995.26 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $10,471.29 | Facility | None | $831.76 | $831.76 | $10,471.29 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $3,388.44 | Professional | None | $831.76 | $1,000.00 | $3,388.44 |
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 $1,047.13 Median $1,479.11 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,479.11 | $2,137.96 |
23 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 $645.65 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $645.65 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $257.04 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $954.99 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $194.98 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $128.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $891.25 | $1,445.44 | $1,445.44 |
BCBS Setting Facility Modifier 50 · Both sides Typical Low $5,370.32 Median $12,882.50 Typical High $26,915.35 | Facility | 50 · Both sides | $5,370.32 | $12,882.50 | $26,915.35 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $2,691.53 Typical High $2,884.03 | Professional | 50 · Both sides | $2,398.83 | $2,691.53 | $2,884.03 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,621.81 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,445.44 | $1,621.81 | $1,737.80 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $181.97 Typical High $194.98 | Professional | 55 · Aftercare only | $158.49 | $181.97 | $194.98 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,122.02 Typical High $1,202.26 | Professional | 62 · Two surgeons | $1,000.00 | $1,122.02 | $1,202.26 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $1,905.46 Median $2,187.76 Typical High $2,344.23 | Professional | 63 · Small infant | $1,905.46 | $2,187.76 | $2,344.23 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,258.93 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,258.93 | $1,348.96 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $288.40 Typical High $309.03 | Professional | 80 · Assistant surgeon | $257.04 | $288.40 | $309.03 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $257.04 Median $288.40 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $257.04 | $288.40 | $309.03 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $257.04 Median $288.40 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $257.04 | $288.40 | $309.03 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $245.47 Typical High $263.03 | Professional | AS · PA/NP assist | $218.78 | $245.47 | $263.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $645.65 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $257.04 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $954.99 | $1,548.82 | $1,548.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $194.98 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $128.82 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $891.25 | $1,445.44 | $1,445.44 |
Where Idaho sits
The same service costs 18.2 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
$1,820
AK $4,074TX $224
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.