How much rates vary
Facilitymedian $2,630 · 10th to 90th $1,175 to $7,244Professionalmedian $1,122 · 10th to 90th $692 to $1,660
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 $645.65 Median $1,023.29 Typical High $1,659.59 | Professional | None | $645.65 | $1,023.29 | $1,659.59 |
BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $8,317.64 | Facility | None | $2,630.27 | $3,090.30 | $8,317.64 |
BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,288.25 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,621.81 | $1,819.70 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,122.02 | Professional | None | $741.31 | $977.24 | $1,122.02 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $4,466.84 Typical High $5,754.40 | Facility | None | $602.56 | $4,466.84 | $5,754.40 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,659.59 | Professional | None | $933.25 | $1,202.26 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,754.23 | Facility | None | $1,174.90 | $1,174.90 | $2,754.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,445.44 | Professional | None | $1,174.90 | $1,174.90 | $1,445.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,585.78 Typical High $10,471.29 | Facility | None | $5,248.07 | $7,585.78 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,348.96 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $562.34 Median $575.44 Typical High $4,265.80 | Facility | None | $562.34 | $575.44 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $851.14 | Professional | None | $562.34 | $562.34 | $851.14 |
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 $630.96 Median $912.01 Typical High $1,348.96 | Professional | None | $630.96 | $912.01 | $1,348.96 |
20 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 $371.54 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $371.54 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $151.36 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $562.34 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $112.20 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $74.13 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $524.81 | $1,148.15 | $1,148.15 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,122.02 Typical High $1,202.26 | Professional | 54 · Surgery only | $954.99 | $1,122.02 | $1,202.26 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $125.89 Typical High $131.83 | Professional | 55 · Aftercare only | $107.15 | $125.89 | $131.83 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $1,258.93 Median $1,513.56 Typical High $1,584.89 | Professional | 63 · Small infant | $1,258.93 | $1,513.56 | $1,584.89 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $870.96 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $741.31 | $870.96 | $933.25 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $199.53 Typical High $213.80 | Professional | 80 · Assistant surgeon | $169.82 | $199.53 | $213.80 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $199.53 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $169.82 | $199.53 | $213.80 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $199.53 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $199.53 | $213.80 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $169.82 Typical High $177.83 | Professional | AS · PA/NP assist | $144.54 | $169.82 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $478.63 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $190.55 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $707.95 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $141.25 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $95.50 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $660.69 | $1,148.15 | $1,148.15 |
Where Idaho sits
The same service costs 3.2 times more in Oklahoma than in Montana. 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
OK $6,513MT $2,047
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.