How much rates vary
Facilitymedian $9,333 · 10th to 90th $2,692 to $27,542Professionalmedian $3,020 · 10th to 90th $398 to $7,079
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 $954.99 Median $4,466.84 Typical High $11,220.18 | Facility | None | $954.99 | $4,466.84 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $3,235.94 Typical High $10,715.19 | Professional | None | $309.03 | $3,235.94 | $10,715.19 |
BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $12,589.25 Typical High $33,113.11 | Facility | None | $10,000.00 | $12,589.25 | $33,113.11 |
BCBS Setting Professional Modifier None Typical Low $478.63 Median $5,370.32 Typical High $7,079.46 | Professional | None | $478.63 | $5,370.32 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $8,317.64 Median $9,332.54 Typical High $12,589.25 | Facility | None | $8,317.64 | $9,332.54 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $630.96 Typical High $6,165.95 | Professional | None | $416.87 | $630.96 | $6,165.95 |
Moda Health Setting Facility Modifier None Typical Low $912.01 Median $5,495.41 Typical High $10,715.19 | Facility | None | $912.01 | $5,495.41 | $10,715.19 |
Moda Health Setting Professional Modifier None Typical Low $398.11 Median $3,548.13 Typical High $10,715.19 | Professional | None | $398.11 | $3,548.13 | $10,715.19 |
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 $512.86 Median $512.86 Typical High $6,309.57 | Facility | None | $512.86 | $512.86 | $6,309.57 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $512.86 Median $6,309.57 Typical High $6,918.31 | Professional | None | $512.86 | $6,309.57 | $6,918.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $19,498.45 Median $27,542.29 Typical High $36,307.81 | Facility | None | $19,498.45 | $27,542.29 | $36,307.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $6,760.83 | Professional | None | $562.34 | $630.96 | $6,760.83 |
Select Health Setting Facility Modifier None Typical Low $3,019.95 Median $3,090.30 Typical High $23,988.33 | Facility | None | $3,019.95 | $3,090.30 | $23,988.33 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $3,019.95 Typical High $4,073.80 | Professional | None | $331.13 | $3,019.95 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,495.41 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,495.41 | $10,715.19 |
United Setting Professional Modifier None Typical Low $338.84 Median $2,630.27 Typical High $6,760.83 | Professional | None | $338.84 | $2,630.27 | $6,760.83 |
18 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 $190.55 Median $457.09 Typical High $5,370.32 | Professional | 52 · Reduced service | $190.55 | $457.09 | $5,370.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $181.97 Typical High $2,137.96 | Professional | 53 · Discontinued | $75.86 | $181.97 | $2,137.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $691.83 Typical High $8,128.31 | Professional | 54 · Surgery only | $281.84 | $691.83 | $8,128.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $138.04 Typical High $1,621.81 | Professional | 55 · Aftercare only | $57.54 | $138.04 | $1,621.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $91.20 Typical High $1,071.52 | Professional | 56 · Pre-op care only | $38.02 | $91.20 | $1,071.52 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $549.54 Typical High $6,165.95 | Professional | 54 · Surgery only | $426.58 | $549.54 | $6,165.95 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $562.34 Typical High $691.83 | Professional | 55 · Aftercare only | $47.86 | $562.34 | $691.83 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $588.84 Median $724.44 Typical High $8,317.64 | Professional | 63 · Small infant | $588.84 | $724.44 | $8,317.64 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $3,981.07 Typical High $4,786.30 | Professional | 78 · Unplanned return to OR | $389.05 | $3,981.07 | $4,786.30 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $97.72 Typical High $1,122.02 | Professional | 80 · Assistant surgeon | $75.86 | $97.72 | $1,122.02 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $75.86 Median $93.33 Typical High $1,122.02 | Professional | 81 · Minimal assistant surgeon | $75.86 | $93.33 | $1,122.02 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $74.13 Median $933.25 Typical High $1,096.48 | Professional | 82 · Assistant surgeon, no resident | $74.13 | $933.25 | $1,096.48 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $79.43 Typical High $933.25 | Professional | AS · PA/NP assist | $63.10 | $79.43 | $933.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $457.09 Typical High $5,370.32 | Professional | 52 · Reduced service | $199.53 | $457.09 | $5,370.32 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $181.97 Typical High $2,137.96 | Professional | 53 · Discontinued | $79.43 | $181.97 | $2,137.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $691.83 Typical High $8,128.31 | Professional | 54 · Surgery only | $295.12 | $691.83 | $8,128.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $138.04 Typical High $1,621.81 | Professional | 55 · Aftercare only | $60.26 | $138.04 | $1,621.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $91.20 Typical High $1,071.52 | Professional | 56 · Pre-op care only | $39.81 | $91.20 | $1,071.52 |
Where Idaho sits
The same service costs 4.6 times more in Alabama than in Maine. 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
AL $19,480ME $4,222
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.