How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,950 to $15,136Professionalmedian $1,950 · 10th to 90th $1,202 to $2,692
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 $1,174.90 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,174.90 | $2,691.53 | $2,691.53 |
BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $6,165.95 Typical High $17,782.79 | Facility | None | $4,073.80 | $6,165.95 | $17,782.79 |
BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,187.76 | Professional | None | $1,778.28 | $2,089.30 | $2,187.76 |
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 $1,348.96 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,348.96 | $1,621.81 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $1,548.82 Median $3,890.45 Typical High $10,232.93 | Facility | None | $1,548.82 | $3,890.45 | $10,232.93 |
Moda Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $2,691.53 | Professional | None | $1,548.82 | $2,137.96 | $2,691.53 |
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 $1,584.89 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,584.89 | $1,949.84 | $1,949.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,949.84 | $1,949.84 | $2,344.23 |
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 $1,819.70 Median $2,187.76 Typical High $2,290.87 | Professional | None | $1,819.70 | $2,187.76 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $954.99 | Facility | None | $933.25 | $933.25 | $954.99 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,412.54 | Professional | None | $933.25 | $933.25 | $1,412.54 |
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 $1,122.02 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,479.11 | $2,290.87 |
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 $616.60 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $616.60 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $245.47 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $912.01 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $181.97 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $123.03 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $851.14 | $1,862.09 | $1,862.09 |
BCBS Setting Facility Modifier 50 · Both sides Typical Low $6,165.95 Median $8,511.38 Typical High $26,915.35 | Facility | 50 · Both sides | $6,165.95 | $8,511.38 | $26,915.35 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,630.27 Median $3,090.30 Typical High $3,235.94 | Professional | 50 · Both sides | $2,630.27 | $3,090.30 | $3,235.94 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,862.09 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,584.89 | $1,862.09 | $1,949.84 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $204.17 Typical High $218.78 | Professional | 55 · Aftercare only | $173.78 | $204.17 | $218.78 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,288.25 Typical High $1,348.96 | Professional | 62 · Two surgeons | $1,096.48 | $1,288.25 | $1,348.96 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $2,089.30 Median $2,454.71 Typical High $2,630.27 | Professional | 63 · Small infant | $2,089.30 | $2,454.71 | $2,630.27 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,445.44 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,445.44 | $1,513.56 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $331.13 Typical High $346.74 | Professional | 80 · Assistant surgeon | $281.84 | $331.13 | $346.74 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $281.84 Median $331.13 Typical High $346.74 | Professional | 81 · Minimal assistant surgeon | $281.84 | $331.13 | $346.74 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $281.84 Median $331.13 Typical High $346.74 | Professional | 82 · Assistant surgeon, no resident | $281.84 | $331.13 | $346.74 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $281.84 Typical High $295.12 | Professional | AS · PA/NP assist | $239.88 | $281.84 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $758.58 | $1,348.96 | $1,348.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $309.03 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,148.15 | $1,995.26 | $1,995.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $229.09 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $154.88 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,862.09 | $1,862.09 |
Where Idaho sits
The same service costs 3.4 times more in Alaska 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
AK $11,546MT $3,436
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.