How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,023 to $14,454Professionalmedian $1,023 · 10th to 90th $676 to $1,413
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 $1,000.00 Median $1,659.59 Typical High $5,495.41 | Facility | None | $1,000.00 | $1,659.59 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $1,023.29 Typical High $1,380.38 | Professional | None | $616.60 | $1,023.29 | $1,380.38 |
BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $6,025.60 Typical High $18,620.87 | Facility | None | $2,754.23 | $6,025.60 | $18,620.87 |
BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,445.44 | Professional | None | $831.76 | $1,096.48 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,047.13 | Professional | None | $616.60 | $776.25 | $1,047.13 |
Moda Health Setting Facility Modifier None Typical Low $630.96 Median $1,380.38 Typical High $9,772.37 | Facility | None | $630.96 | $1,380.38 | $9,772.37 |
Moda Health Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,380.38 | Professional | None | $741.31 | $1,122.02 | $1,380.38 |
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 $891.25 Median $891.25 Typical High $1,348.96 | Facility | None | $891.25 | $891.25 | $1,348.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,698.24 | Professional | None | $891.25 | $1,122.02 | $1,698.24 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,621.81 | Professional | None | $977.24 | $1,202.26 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $645.65 Typical High $10,000.00 | Facility | None | $630.96 | $645.65 | $10,000.00 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $4,168.69 | Professional | None | $501.19 | $630.96 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,288.25 | Professional | None | $524.81 | $794.33 | $1,288.25 |
28 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 $309.03 Median $512.86 Typical High $691.83 | Professional | 52 · Reduced service | $309.03 | $512.86 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $204.17 Typical High $275.42 | Professional | 53 · Discontinued | $123.03 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $758.58 Typical High $1,023.29 | Professional | 54 · Surgery only | $457.09 | $758.58 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $151.36 Typical High $208.93 | Professional | 55 · Aftercare only | $91.20 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $102.33 Typical High $138.04 | Professional | 56 · Pre-op care only | $61.66 | $102.33 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $707.95 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $426.58 | $707.95 | $977.24 |
BCBS Setting Facility Modifier 50 · Both sides Typical Low $4,073.80 Median $8,709.64 Typical High $28,183.83 | Facility | 50 · Both sides | $4,073.80 | $8,709.64 | $28,183.83 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,862.09 Typical High $2,187.76 | Professional | 50 · Both sides | $1,258.93 | $1,862.09 | $2,187.76 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,096.48 Typical High $1,318.26 | Professional | 54 · Surgery only | $741.31 | $1,096.48 | $1,318.26 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $83.18 | $120.23 | $144.54 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $630.96 Typical High $933.25 | Professional | 62 · Two surgeons | $524.81 | $630.96 | $933.25 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $1,023.29 Median $1,445.44 Typical High $1,737.80 | Professional | 63 · Small infant | $1,023.29 | $1,445.44 | $1,737.80 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $707.95 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $575.44 | $707.95 | $1,000.00 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $190.55 Typical High $234.42 | Professional | 80 · Assistant surgeon | $138.04 | $190.55 | $234.42 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $131.83 Median $177.83 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $131.83 | $177.83 | $234.42 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $162.18 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $162.18 | $234.42 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $151.36 Typical High $194.98 | Professional | AS · PA/NP assist | $117.49 | $151.36 | $194.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $512.86 Typical High $691.83 | Professional | 52 · Reduced service | $309.03 | $512.86 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $204.17 Typical High $275.42 | Professional | 53 · Discontinued | $123.03 | $204.17 | $275.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $758.58 Typical High $1,023.29 | Professional | 54 · Surgery only | $457.09 | $758.58 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $151.36 Typical High $208.93 | Professional | 55 · Aftercare only | $91.20 | $151.36 | $208.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $102.33 Typical High $138.04 | Professional | 56 · Pre-op care only | $61.66 | $102.33 | $138.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $707.95 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $426.58 | $707.95 | $977.24 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,659.59 Typical High $2,238.72 | Professional | 50 · Both sides | $1,659.59 | $1,659.59 | $2,238.72 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $776.25 | $776.25 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $147.91 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $147.91 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $691.83 Typical High $933.25 | Professional | 62 · Two surgeons | $691.83 | $691.83 | $933.25 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,122.02 |
Where Idaho sits
The same service costs 9.5 times more in Colorado than in West Virginia. 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.
Physician feeFacility fee
CO $13,590WV $1,432
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.