How much rates vary
Facilitymedian $4,074 · 10th to 90th $2,042 to $14,125Professionalmedian $2,042 · 10th to 90th $1,318 to $2,884
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $2,884.03 Typical High $2,884.03 | Professional | None | $1,318.26 | $2,884.03 | $2,884.03 |
BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $5,754.40 Typical High $15,135.61 | Facility | None | $3,548.13 | $5,754.40 | $15,135.61 |
BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $2,344.23 | Professional | None | $1,862.09 | $2,238.72 | $2,344.23 |
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 $1,445.44 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,698.24 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $1,023.29 Median $2,884.03 Typical High $5,495.41 | Facility | None | $1,023.29 | $2,884.03 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,290.87 Typical High $2,884.03 | Professional | None | $1,621.81 | $2,290.87 | $2,884.03 |
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 $1,659.59 Median $2,041.74 Typical High $2,041.74 | Facility | None | $1,659.59 | $2,041.74 | $2,041.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,454.71 | Professional | None | $2,041.74 | $2,041.74 | $2,454.71 |
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 $2,238.72 Median $2,344.23 Typical High $2,454.71 | Professional | None | $2,238.72 | $2,344.23 | $2,454.71 |
Select Health Setting Facility Modifier None Typical Low $977.24 Median $1,000.00 Typical High $10,715.19 | Facility | None | $977.24 | $1,000.00 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,479.11 | Professional | None | $977.24 | $977.24 | $1,479.11 |
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 $1,174.90 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,949.84 | $2,884.03 |
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 $812.83 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $812.83 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $323.59 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,230.27 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $245.47 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $162.18 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,995.26 | $1,995.26 |
BCBS Setting Facility Modifier 50 · Both sides Typical Low $5,128.61 Median $8,511.38 Typical High $22,908.68 | Facility | 50 · Both sides | $5,128.61 | $8,511.38 | $22,908.68 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,754.23 Median $3,311.31 Typical High $3,467.37 | Professional | 50 · Both sides | $2,754.23 | $3,311.31 | $3,467.37 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,949.84 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,659.59 | $1,949.84 | $2,041.74 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $218.78 Typical High $229.09 | Professional | 55 · Aftercare only | $181.97 | $218.78 | $229.09 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,348.96 Typical High $1,412.54 | Professional | 62 · Two surgeons | $1,148.15 | $1,348.96 | $1,412.54 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $2,187.76 Median $2,630.27 Typical High $2,754.23 | Professional | 63 · Small infant | $2,187.76 | $2,630.27 | $2,754.23 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,513.56 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,513.56 | $1,584.89 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $346.74 Typical High $363.08 | Professional | 80 · Assistant surgeon | $295.12 | $346.74 | $363.08 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $346.74 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $295.12 | $346.74 | $363.08 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $346.74 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $346.74 | $363.08 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $295.12 Typical High $309.03 | Professional | AS · PA/NP assist | $251.19 | $295.12 | $309.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $812.83 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $812.83 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $331.13 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,230.27 | $2,137.96 | $2,137.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $245.47 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $162.18 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,995.26 | $1,995.26 |
Where Idaho sits
The same service costs 6.8 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
$2,291
AK $4,786TX $708
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.