How much rates vary
Facilitymedian $282 · 10th to 90th $151 to $1,445Professionalmedian $251 · 10th to 90th $155 to $389
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $323.59 Typical High $524.81 | Professional | None | $154.88 | $323.59 | $524.81 |
BCBS Setting Facility Modifier None Typical Low $158.49 Median $446.68 Typical High $1,584.89 | Facility | None | $158.49 | $446.68 | $1,584.89 |
BCBS Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $389.05 | Professional | None | $186.21 | $257.04 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $154.88 Typical High $213.80 | Facility | None | $138.04 | $154.88 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $281.84 | Professional | None | $151.36 | $194.98 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $457.09 Typical High $5,495.41 | Facility | None | $123.03 | $457.09 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $323.59 Typical High $524.81 | Professional | None | $162.18 | $323.59 | $524.81 |
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 $190.55 Median $190.55 Typical High $354.81 | Facility | None | $190.55 | $190.55 | $354.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $190.55 Median $346.74 Typical High $363.08 | Professional | None | $190.55 | $346.74 | $363.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $870.96 Median $1,258.93 Typical High $1,819.70 | Facility | None | $870.96 | $1,258.93 | $1,819.70 |
Regence BlueShield Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $354.81 | Professional | None | $213.80 | $239.88 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $169.82 Median $173.78 Typical High $954.99 | Facility | None | $169.82 | $173.78 | $954.99 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $223.87 | Professional | None | $120.23 | $169.82 | $223.87 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $316.23 | Professional | None | $117.49 | $194.98 | $316.23 |
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 $75.86 Median $162.18 Typical High $263.03 | Professional | 52 · Reduced service | $75.86 | $162.18 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $64.57 Typical High $104.71 | Professional | 53 · Discontinued | $30.90 | $64.57 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $239.88 Typical High $389.05 | Professional | 54 · Surgery only | $114.82 | $239.88 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $47.86 Typical High $77.62 | Professional | 55 · Aftercare only | $22.91 | $47.86 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $32.36 Typical High $52.48 | Professional | 56 · Pre-op care only | $15.49 | $32.36 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $223.87 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $107.15 | $223.87 | $363.08 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $194.98 Typical High $331.13 | Professional | 54 · Surgery only | $158.49 | $194.98 | $331.13 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $20.89 Typical High $38.02 | Professional | 55 · Aftercare only | $17.78 | $20.89 | $38.02 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $213.80 Median $251.19 Typical High $446.68 | Professional | 63 · Small infant | $213.80 | $251.19 | $446.68 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $144.54 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $123.03 | $144.54 | $257.04 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.18 Median $54.95 Typical High $64.57 | Professional | 80 · Assistant surgeon | $28.18 | $54.95 | $64.57 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.18 Median $34.67 Typical High $63.10 | Professional | 81 · Minimal assistant surgeon | $28.18 | $34.67 | $63.10 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $31.62 Median $34.67 Typical High $58.88 | Professional | 82 · Assistant surgeon, no resident | $31.62 | $34.67 | $58.88 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $26.92 Median $28.84 Typical High $50.12 | Professional | AS · PA/NP assist | $26.92 | $28.84 | $50.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $162.18 Typical High $263.03 | Professional | 52 · Reduced service | $77.62 | $162.18 | $263.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $64.57 Typical High $104.71 | Professional | 53 · Discontinued | $30.90 | $64.57 | $104.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $239.88 Typical High $389.05 | Professional | 54 · Surgery only | $114.82 | $239.88 | $389.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $47.86 Typical High $77.62 | Professional | 55 · Aftercare only | $22.91 | $47.86 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $32.36 Typical High $52.48 | Professional | 56 · Pre-op care only | $15.49 | $32.36 | $52.48 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $223.87 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $107.15 | $223.87 | $363.08 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $239.88 Typical High $239.88 | Professional | 54 · Surgery only | $151.36 | $239.88 | $239.88 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $21.38 | $34.67 | $34.67 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $257.04 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $162.18 | $257.04 | $257.04 |
Where Idaho sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 9th of 51
$251
AK $437NJ $126
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.