How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,349 to $18,621Professionalmedian $1,230 · 10th to 90th $851 to $1,479
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $1,348.96 | Professional | None | $891.25 | $1,348.96 | $1,348.96 |
BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $9,772.37 Typical High $22,908.68 | Facility | None | $2,691.53 | $9,772.37 | $22,908.68 |
BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,513.56 | Professional | None | $1,174.90 | $1,380.38 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $3,981.07 Typical High $5,370.32 | Facility | None | $3,548.13 | $3,981.07 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,318.26 | Professional | None | $977.24 | $1,122.02 | $1,318.26 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $1,348.96 Typical High $5,495.41 | Facility | None | $645.65 | $1,348.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $1,479.11 | Professional | None | $891.25 | $1,348.96 | $1,479.11 |
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 $1,096.48 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,096.48 | $1,348.96 | $1,348.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,348.96 | $2,344.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $13,182.57 Median $18,620.87 Typical High $24,547.09 | Facility | None | $13,182.57 | $18,620.87 | $24,547.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,479.11 | Professional | None | $1,174.90 | $1,174.90 | $1,479.11 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $660.69 Typical High $9,332.54 | Facility | None | $645.65 | $660.69 | $9,332.54 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $977.24 | Professional | None | $645.65 | $645.65 | $977.24 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,548.82 | Professional | None | $758.58 | $1,071.52 | $1,548.82 |
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 $446.68 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $446.68 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $177.83 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $676.08 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $134.90 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $89.13 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $630.96 | $933.25 | $933.25 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,288.25 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,096.48 | $1,288.25 | $1,348.96 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $144.54 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $144.54 | $151.36 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $891.25 Typical High $954.99 | Professional | 62 · Two surgeons | $758.58 | $891.25 | $954.99 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $1,445.44 Median $1,737.80 Typical High $1,819.70 | Professional | 63 · Small infant | $1,445.44 | $1,737.80 | $1,819.70 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,000.00 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $851.14 | $1,000.00 | $1,071.52 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $229.09 Typical High $239.88 | Professional | 80 · Assistant surgeon | $194.98 | $229.09 | $239.88 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $229.09 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $194.98 | $229.09 | $239.88 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $229.09 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $229.09 | $239.88 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $194.98 Typical High $204.17 | Professional | AS · PA/NP assist | $165.96 | $194.98 | $204.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $446.68 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $177.83 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $676.08 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $134.90 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $89.13 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $630.96 | $933.25 | $933.25 |
Where Idaho sits
The same service costs 6.8 times more in Oklahoma 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· 14th of 51
$1,349
OK $3,548TX $525
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.