How much rates vary
Facilitymedian $871 · 10th to 90th $550 to $4,365Professionalmedian $1,259 · 10th to 90th $912 to $1,514
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,380.38 Typical High $1,380.38 | Professional | None | $933.25 | $1,380.38 | $1,380.38 |
BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $3,162.28 Typical High $3,890.45 | Facility | None | $2,951.21 | $3,162.28 | $3,890.45 |
BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,318.26 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $1,380.38 Typical High $12,589.25 | Facility | None | $151.36 | $1,380.38 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,148.15 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $831.76 Median $1,380.38 Typical High $5,495.41 | Facility | None | $831.76 | $1,380.38 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,380.38 Typical High $1,548.82 | Professional | None | $933.25 | $1,380.38 | $1,548.82 |
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 $1,584.89 | Professional | None | $1,348.96 | $1,348.96 | $1,584.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,548.82 | Professional | None | $1,230.27 | $1,230.27 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $691.83 | Facility | None | $645.65 | $645.65 | $691.83 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,023.29 | Professional | None | $645.65 | $645.65 | $1,023.29 |
United Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $870.96 | Facility | None | $436.52 | $676.08 | $870.96 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,174.90 Typical High $1,659.59 | Professional | None | $776.25 | $1,174.90 | $1,659.59 |
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 $467.74 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $467.74 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $186.21 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $691.83 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $141.25 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $93.33 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $645.65 | $977.24 | $977.24 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,318.26 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,096.48 | $1,318.26 | $1,380.38 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $144.54 Typical High $151.36 | Professional | 55 · Aftercare only | $123.03 | $144.54 | $151.36 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $912.01 Typical High $954.99 | Professional | 62 · Two surgeons | $758.58 | $912.01 | $954.99 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $1,479.11 Median $1,737.80 Typical High $1,819.70 | Professional | 63 · Small infant | $1,479.11 | $1,737.80 | $1,819.70 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,023.29 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $851.14 | $1,023.29 | $1,071.52 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $234.42 Typical High $245.47 | Professional | 80 · Assistant surgeon | $194.98 | $234.42 | $245.47 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $234.42 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $194.98 | $234.42 | $245.47 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $234.42 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $234.42 | $245.47 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $199.53 Typical High $208.93 | Professional | AS · PA/NP assist | $165.96 | $199.53 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $467.74 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $186.21 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $691.83 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $141.25 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $93.33 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $645.65 | $977.24 | $977.24 |
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· 13th of 51
$1,259
AK $3,236UT $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.