How much rates vary
Facilitymedian $2,089 · 10th to 90th $933 to $5,248Professionalmedian $832 · 10th to 90th $251 to $1,445
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 $5,495.41 Typical High $7,079.46 | Facility | None | $1,412.54 | $5,495.41 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,445.44 Typical High $1,445.44 | Professional | None | $776.25 | $1,445.44 | $1,445.44 |
BCBS Setting Facility Modifier None Typical Low $2,454.71 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,454.71 | $3,467.37 | $5,011.87 |
BCBS Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $1,230.27 | Professional | None | $251.19 | $295.12 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $954.99 | Professional | None | $724.44 | $831.76 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $1,445.44 Typical High $6,456.54 | Facility | None | $616.60 | $1,445.44 | $6,456.54 |
Moda Health Setting Professional Modifier None Typical Low $380.19 Median $1,445.44 Typical High $1,445.44 | Professional | None | $380.19 | $1,445.44 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $213.80 Typical High $251.19 | Professional | None | $30.20 | $213.80 | $251.19 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,122.02 | Facility | None | $912.01 | $1,122.02 | $1,122.02 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,122.02 | $1,412.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,230.27 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $302.00 Typical High $5,128.61 | Facility | None | $295.12 | $302.00 | $5,128.61 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $295.12 | Professional | None | $251.19 | $295.12 | $295.12 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,818.38 | Facility | None | $1,412.54 | $1,819.70 | $2,818.38 |
United Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $575.44 | Professional | None | $309.03 | $426.58 | $575.44 |
20 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 $389.05 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $389.05 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $154.88 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $575.44 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $114.82 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $77.62 | $144.54 | $144.54 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $416.87 Typical High $436.52 | Professional | 50 · Both sides | $371.54 | $416.87 | $436.52 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $251.19 Typical High $263.03 | Professional | 54 · Surgery only | $223.87 | $251.19 | $263.03 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.18 Typical High $29.51 | Professional | 55 · Aftercare only | $25.12 | $28.18 | $29.51 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $154.88 Median $173.78 Typical High $181.97 | Professional | 62 · Two surgeons | $154.88 | $173.78 | $181.97 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $302.00 Median $338.84 Typical High $354.81 | Professional | 63 · Small infant | $302.00 | $338.84 | $354.81 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $194.98 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $173.78 | $194.98 | $204.17 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $44.67 Typical High $46.77 | Professional | 80 · Assistant surgeon | $39.81 | $44.67 | $46.77 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $39.81 Median $44.67 Typical High $46.77 | Professional | 81 · Minimal assistant surgeon | $39.81 | $44.67 | $46.77 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $39.81 Median $44.67 Typical High $46.77 | Professional | 82 · Assistant surgeon, no resident | $39.81 | $44.67 | $46.77 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $33.88 Median $38.02 Typical High $39.81 | Professional | AS · PA/NP assist | $33.88 | $38.02 | $39.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $389.05 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $154.88 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $575.44 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $114.82 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $77.62 | $144.54 | $144.54 |
Where Idaho sits
The same service costs 10.0 times more in Alaska than in Kentucky. 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· 12th of 51
$832
AK $2,455KY $245
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.