How much rates vary
Facilitymedian $1,995 · 10th to 90th $1,175 to $6,310Professionalmedian $1,175 · 10th to 90th $776 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 $4,466.84 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 $794.33 Median $1,513.56 Typical High $1,513.56 | Professional | None | $794.33 | $1,513.56 | $1,513.56 |
BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $3,090.30 Typical High $7,585.78 | Facility | None | $1,659.59 | $3,090.30 | $7,585.78 |
BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,230.27 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,995.26 | Facility | None | $1,318.26 | $1,479.11 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $977.24 | Professional | None | $741.31 | $870.96 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $5,495.41 | Facility | None | $562.34 | $1,513.56 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $794.33 Median $1,513.56 Typical High $1,513.56 | Professional | None | $794.33 | $1,513.56 | $1,513.56 |
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 $954.99 Median $1,174.90 Typical High $1,174.90 | Facility | None | $954.99 | $1,174.90 | $1,174.90 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,174.90 | $1,548.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,388.44 Median $5,011.87 Typical High $6,309.57 | Facility | None | $3,388.44 | $5,011.87 | $6,309.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,096.48 | $1,288.25 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $9,332.54 | Facility | None | $562.34 | $562.34 | $9,332.54 |
Select Health Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $1,348.96 | Professional | None | $562.34 | $630.96 | $1,348.96 |
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 $630.96 Median $870.96 Typical High $1,258.93 | Professional | None | $630.96 | $870.96 | $1,258.93 |
22 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 $398.11 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $398.11 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $158.49 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $602.56 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $120.23 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $79.43 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $562.34 | $1,071.52 | $1,071.52 |
BCBS Setting Facility Modifier 50 · Both sides Typical Low $2,454.71 Median $4,677.35 Typical High $11,220.18 | Facility | 50 · Both sides | $2,454.71 | $4,677.35 | $11,220.18 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,819.70 Typical High $1,949.84 | Professional | 50 · Both sides | $1,621.81 | $1,819.70 | $1,949.84 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,096.48 Typical High $1,174.90 | Professional | 54 · Surgery only | $977.24 | $1,096.48 | $1,174.90 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $120.23 Typical High $131.83 | Professional | 55 · Aftercare only | $107.15 | $120.23 | $131.83 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $1,288.25 Median $1,445.44 Typical High $1,584.89 | Professional | 63 · Small infant | $1,288.25 | $1,445.44 | $1,584.89 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $851.14 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $758.58 | $851.14 | $912.01 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $194.98 Typical High $208.93 | Professional | 80 · Assistant surgeon | $173.78 | $194.98 | $208.93 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $173.78 Median $194.98 Typical High $208.93 | Professional | 81 · Minimal assistant surgeon | $173.78 | $194.98 | $208.93 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $173.78 Median $194.98 Typical High $208.93 | Professional | 82 · Assistant surgeon, no resident | $173.78 | $194.98 | $208.93 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $162.18 Typical High $177.83 | Professional | AS · PA/NP assist | $147.91 | $162.18 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $398.11 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $158.49 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $602.56 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $120.23 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $79.43 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $562.34 | $1,071.52 | $1,071.52 |
Where Idaho sits
The same service costs 5.8 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· 8th of 51
$1,230
AK $2,570UT $447
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.