How much rates vary
Facilitymedian $4,074 · 10th to 90th $2,089 to $14,125Professionalmedian $3,090 · 10th to 90th $1,950 to $4,266
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $4,265.80 Typical High $4,265.80 | Professional | None | $1,905.46 | $4,265.80 | $4,265.80 |
BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $5,754.40 Typical High $15,135.61 | Facility | None | $3,235.94 | $5,754.40 | $15,135.61 |
BCBS Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $3,467.37 | Professional | None | $2,884.03 | $3,388.44 | $3,467.37 |
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 $2,089.30 Median $2,570.40 Typical High $2,951.21 | Professional | None | $2,089.30 | $2,570.40 | $2,951.21 |
Moda Health Setting Facility Modifier None Typical Low $1,348.96 Median $4,265.80 Typical High $6,025.60 | Facility | None | $1,348.96 | $4,265.80 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $4,265.80 | Professional | None | $2,511.89 | $3,311.31 | $4,265.80 |
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 $2,511.89 Median $3,090.30 Typical High $3,090.30 | Facility | None | $2,511.89 | $3,090.30 | $3,090.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,801.89 | Professional | None | $3,090.30 | $3,090.30 | $3,801.89 |
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 $2,884.03 Median $3,467.37 Typical High $3,630.78 | Professional | None | $2,884.03 | $3,467.37 | $3,630.78 |
Select Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $10,715.19 | Facility | None | $1,479.11 | $1,513.56 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,479.11 | $1,479.11 | $2,187.76 |
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 $1,659.59 Median $2,570.40 Typical High $3,630.78 | Professional | None | $1,659.59 | $2,570.40 | $3,630.78 |
21 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 $954.99 Median $2,137.96 Typical High $2,137.96 | Professional | 52 · Reduced service | $954.99 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $380.19 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,445.44 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $288.40 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $190.55 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $1,348.96 | $2,951.21 | $2,951.21 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,884.03 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,511.89 | $2,884.03 | $3,090.30 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $323.59 Typical High $346.74 | Professional | 55 · Aftercare only | $275.42 | $323.59 | $346.74 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,737.80 Median $1,995.26 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,737.80 | $1,995.26 | $2,187.76 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $3,311.31 Median $3,890.45 Typical High $4,168.69 | Professional | 63 · Small infant | $3,311.31 | $3,890.45 | $4,168.69 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $2,238.72 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,949.84 | $2,238.72 | $2,454.71 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $446.68 Median $512.86 Typical High $549.54 | Professional | 80 · Assistant surgeon | $446.68 | $512.86 | $549.54 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $446.68 Median $512.86 Typical High $549.54 | Professional | 81 · Minimal assistant surgeon | $446.68 | $512.86 | $549.54 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $446.68 Median $512.86 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $446.68 | $512.86 | $549.54 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $436.52 Typical High $467.74 | Professional | AS · PA/NP assist | $380.19 | $436.52 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,258.93 Median $2,137.96 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,258.93 | $2,137.96 | $2,137.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $501.19 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,862.09 | $3,162.28 | $3,162.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $371.54 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $251.19 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $1,737.80 | $2,951.21 | $2,951.21 |
Where Idaho sits
The same service costs 7.1 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· 11th of 51
$3,236
AK $7,079TX $1,000
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.