How much rates vary
Facilitymedian $9,772 · 10th to 90th $2,951 to $26,303Professionalmedian $3,802 · 10th to 90th $2,692 to $4,571
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 $4,677.35 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,677.35 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $4,365.16 Typical High $4,365.16 | Professional | None | $2,691.53 | $4,365.16 | $4,365.16 |
BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $11,220.18 Typical High $30,902.95 | Facility | None | $7,943.28 | $11,220.18 | $30,902.95 |
BCBS Setting Professional Modifier None Typical Low $3,388.44 Median $3,981.07 Typical High $4,265.80 | Professional | None | $3,388.44 | $3,981.07 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $10,232.93 Median $11,481.54 Typical High $15,488.17 | Facility | None | $10,232.93 | $11,481.54 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $3,388.44 | Professional | None | $2,570.40 | $2,951.21 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $1,737.80 Median $4,365.16 Typical High $5,495.41 | Facility | None | $1,737.80 | $4,365.16 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $2,691.53 Median $4,365.16 Typical High $5,128.61 | Professional | None | $2,691.53 | $4,365.16 | $5,128.61 |
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 $2,951.21 Median $3,630.78 Typical High $3,630.78 | Facility | None | $2,951.21 | $3,630.78 | $3,630.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,677.35 | Professional | None | $3,630.78 | $3,630.78 | $4,677.35 |
Regence BlueShield Setting Facility Modifier None Typical Low $19,054.61 Median $25,118.86 Typical High $31,622.78 | Facility | None | $19,054.61 | $25,118.86 | $31,622.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,890.45 Median $4,265.80 Typical High $5,128.61 | Professional | None | $3,890.45 | $4,265.80 | $5,128.61 |
Select Health Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,862.09 | Facility | None | $1,737.80 | $1,737.80 | $1,862.09 |
Select Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $10,471.29 | Professional | None | $1,737.80 | $2,137.96 | $10,471.29 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,495.41 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,495.41 | $10,715.19 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $3,162.28 Typical High $4,677.35 | Professional | None | $2,344.23 | $3,162.28 | $4,677.35 |
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 $1,348.96 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,348.96 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $870.96 Typical High $870.96 | Professional | 53 · Discontinued | $537.03 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $3,235.94 Typical High $3,235.94 | Professional | 54 · Surgery only | $2,041.74 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $407.38 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $269.15 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $3,019.95 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $1,905.46 | $3,019.95 | $3,019.95 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,467.37 Typical High $3,715.35 | Professional | 54 · Surgery only | $3,019.95 | $3,467.37 | $3,715.35 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $380.19 Typical High $407.38 | Professional | 55 · Aftercare only | $338.84 | $380.19 | $407.38 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,089.30 Median $2,398.83 Typical High $2,570.40 | Professional | 62 · Two surgeons | $2,089.30 | $2,398.83 | $2,570.40 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $4,073.80 Median $4,570.88 Typical High $4,897.79 | Professional | 63 · Small infant | $4,073.80 | $4,570.88 | $4,897.79 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,691.53 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,691.53 | $2,884.03 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $537.03 Median $616.60 Typical High $660.69 | Professional | 80 · Assistant surgeon | $537.03 | $616.60 | $660.69 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $537.03 Median $616.60 Typical High $660.69 | Professional | 81 · Minimal assistant surgeon | $537.03 | $616.60 | $660.69 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $537.03 Median $616.60 Typical High $660.69 | Professional | 82 · Assistant surgeon, no resident | $537.03 | $616.60 | $660.69 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $457.09 Median $524.81 Typical High $562.34 | Professional | AS · PA/NP assist | $457.09 | $524.81 | $562.34 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,348.96 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,348.96 | $2,187.76 | $2,187.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $870.96 Typical High $870.96 | Professional | 53 · Discontinued | $537.03 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $3,235.94 Typical High $3,235.94 | Professional | 54 · Surgery only | $2,041.74 | $3,235.94 | $3,235.94 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $407.38 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $269.15 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $3,019.95 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $1,905.46 | $3,019.95 | $3,019.95 |
Where Idaho sits
The same service costs 6.5 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· 11th of 51
$3,802
AK $8,710TX $1,349
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.