How much rates vary
Facilitymedian $2,188 · 10th to 90th $794 to $7,762Professionalmedian $794 · 10th to 90th $525 to $933
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 $549.54 Median $851.14 Typical High $851.14 | Professional | None | $549.54 | $851.14 | $851.14 |
BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $2,691.53 Typical High $8,511.38 | Facility | None | $1,621.81 | $2,691.53 | $8,511.38 |
BCBS Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $891.25 | Professional | None | $724.44 | $851.14 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,754.23 | Facility | None | $1,819.70 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $660.69 | Professional | None | $478.63 | $575.44 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $426.58 Median $851.14 Typical High $5,495.41 | Facility | None | $426.58 | $851.14 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $1,023.29 | Professional | None | $549.54 | $851.14 | $1,023.29 |
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 $645.65 Median $794.33 Typical High $794.33 | Facility | None | $645.65 | $794.33 | $794.33 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,000.00 | Professional | None | $794.33 | $794.33 | $1,000.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $10,715.19 | Facility | None | $5,495.41 | $7,762.47 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,023.29 | Professional | None | $776.25 | $870.96 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $380.19 Typical High $4,168.69 | Facility | None | $371.54 | $380.19 | $4,168.69 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $1,862.09 | Professional | None | $371.54 | $426.58 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $891.25 | Professional | None | $436.52 | $602.56 | $891.25 |
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 $275.42 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $275.42 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $109.65 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $407.38 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $81.28 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $54.95 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $380.19 | $602.56 | $602.56 |
BCBS Setting Facility Modifier 50 · Both sides Typical Low $2,344.23 Median $3,890.45 Typical High $12,589.25 | Facility | 50 · Both sides | $2,344.23 | $3,890.45 | $12,589.25 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,230.27 Typical High $1,318.26 | Professional | 50 · Both sides | $1,096.48 | $1,230.27 | $1,318.26 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $724.44 Typical High $794.33 | Professional | 54 · Surgery only | $660.69 | $724.44 | $794.33 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $81.28 Typical High $89.13 | Professional | 55 · Aftercare only | $72.44 | $81.28 | $89.13 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $512.86 Typical High $549.54 | Professional | 62 · Two surgeons | $457.09 | $512.86 | $549.54 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $870.96 Median $977.24 Typical High $1,071.52 | Professional | 63 · Small infant | $870.96 | $977.24 | $1,071.52 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $616.60 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $128.82 Typical High $141.25 | Professional | 80 · Assistant surgeon | $117.49 | $128.82 | $141.25 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $117.49 Median $128.82 Typical High $141.25 | Professional | 81 · Minimal assistant surgeon | $117.49 | $128.82 | $141.25 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $117.49 Median $128.82 Typical High $141.25 | Professional | 82 · Assistant surgeon, no resident | $117.49 | $128.82 | $141.25 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $109.65 Typical High $120.23 | Professional | AS · PA/NP assist | $100.00 | $109.65 | $120.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $275.42 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $109.65 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $407.38 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $81.28 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $54.95 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $380.19 | $602.56 | $602.56 |
Where Idaho sits
The same service costs 8.3 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· 8th of 51
$832
AK $1,738TX $209
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.