How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,072 to $12,882Professionalmedian $977 · 10th to 90th $692 to $1,202
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 $724.44 Median $1,071.52 Typical High $1,071.52 | Professional | None | $724.44 | $1,071.52 | $1,071.52 |
BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,918.31 Typical High $15,135.61 | Facility | None | $2,884.03 | $6,918.31 | $15,135.61 |
BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,202.26 | Professional | None | $954.99 | $1,096.48 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $2,818.38 Typical High $3,801.89 | Facility | None | $2,511.89 | $2,818.38 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,047.13 | Professional | None | $758.58 | $891.25 | $1,047.13 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $1,071.52 Typical High $4,466.84 | Facility | None | $501.19 | $1,071.52 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,202.26 | Professional | None | $724.44 | $1,071.52 | $1,202.26 |
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 $870.96 Median $1,071.52 Typical High $1,071.52 | Facility | None | $870.96 | $1,071.52 | $1,071.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,071.52 | $1,862.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,511.38 Median $12,302.69 Typical High $16,218.10 | Facility | None | $8,511.38 | $12,302.69 | $16,218.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,202.26 | Professional | None | $954.99 | $954.99 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $512.86 Typical High $6,918.31 | Facility | None | $501.19 | $512.86 | $6,918.31 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $794.33 | Professional | None | $501.19 | $501.19 | $794.33 |
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 $602.56 Median $870.96 Typical High $1,230.27 | Professional | None | $602.56 | $870.96 | $1,230.27 |
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 $363.08 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $363.08 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $144.54 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $537.03 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $107.15 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $72.44 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $501.19 | $758.58 | $758.58 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,023.29 Typical High $1,071.52 | Professional | 54 · Surgery only | $851.14 | $1,023.29 | $1,071.52 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $112.20 Typical High $120.23 | Professional | 55 · Aftercare only | $95.50 | $112.20 | $120.23 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $707.95 Typical High $741.31 | Professional | 62 · Two surgeons | $602.56 | $707.95 | $741.31 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $1,148.15 Median $1,348.96 Typical High $1,445.44 | Professional | 63 · Small infant | $1,148.15 | $1,348.96 | $1,445.44 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $794.33 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $676.08 | $794.33 | $831.76 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $181.97 Typical High $190.55 | Professional | 80 · Assistant surgeon | $151.36 | $181.97 | $190.55 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $181.97 Typical High $190.55 | Professional | 81 · Minimal assistant surgeon | $151.36 | $181.97 | $190.55 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $181.97 Typical High $190.55 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $181.97 | $190.55 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $154.88 Typical High $162.18 | Professional | AS · PA/NP assist | $128.82 | $154.88 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $363.08 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $144.54 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $537.03 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $107.15 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $72.44 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $501.19 | $758.58 | $758.58 |
Where Idaho sits
The same service costs 6.2 times more in Alaska than in Utah. 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
$1,072
AK $2,512UT $407
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.