How much rates vary
Facilitymedian $3,802 · 10th to 90th $2,089 to $15,136Professionalmedian $2,951 · 10th to 90th $2,089 to $3,548
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 $1,949.84 Median $3,311.31 Typical High $3,311.31 | Professional | None | $1,949.84 | $3,311.31 | $3,311.31 |
BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $9,332.54 Typical High $17,782.79 | Facility | None | $3,467.37 | $9,332.54 | $17,782.79 |
BCBS Setting Professional Modifier None Typical Low $2,884.03 Median $3,235.94 Typical High $3,548.13 | Professional | None | $2,884.03 | $3,235.94 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,011.87 | Facility | None | $3,311.31 | $3,715.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $3,235.94 | Professional | None | $2,344.23 | $2,691.53 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $1,513.56 Median $3,311.31 Typical High $5,495.41 | Facility | None | $1,513.56 | $3,311.31 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $2,454.71 Median $3,162.28 Typical High $3,311.31 | Professional | None | $2,454.71 | $3,162.28 | $3,311.31 |
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 $2,570.40 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,570.40 | $2,951.21 | $2,951.21 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,754.23 Median $2,951.21 Typical High $6,165.95 | Professional | None | $2,754.23 | $2,951.21 | $6,165.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,162.28 | Professional | None | $2,884.03 | $2,884.03 | $3,162.28 |
Select Health Setting Facility Modifier None Typical Low $1,513.56 Median $1,548.82 Typical High $10,964.78 | Facility | None | $1,513.56 | $1,548.82 | $10,964.78 |
Select Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,513.56 | $1,513.56 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $2,754.23 Typical High $3,890.45 | Professional | None | $1,819.70 | $2,754.23 | $3,890.45 |
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 $977.24 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $977.24 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $389.05 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,445.44 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $288.40 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $194.98 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,348.96 | $2,344.23 | $2,344.23 |
BCBS Setting Facility Modifier 50 · Both sides Typical Low $5,248.07 Median $14,125.38 Typical High $26,915.35 | Facility | 50 · Both sides | $5,248.07 | $14,125.38 | $26,915.35 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $4,265.80 Median $5,128.61 Typical High $6,918.31 | Professional | 50 · Both sides | $4,265.80 | $5,128.61 | $6,918.31 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $3,019.95 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,570.40 | $3,019.95 | $3,162.28 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $338.84 Typical High $354.81 | Professional | 55 · Aftercare only | $281.84 | $338.84 | $354.81 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $3,388.44 Median $4,073.80 Typical High $4,265.80 | Professional | 63 · Small infant | $3,388.44 | $4,073.80 | $4,265.80 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,344.23 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,344.23 | $2,511.89 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $457.09 Median $537.03 Typical High $562.34 | Professional | 80 · Assistant surgeon | $457.09 | $537.03 | $562.34 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $457.09 Median $537.03 Typical High $562.34 | Professional | 81 · Minimal assistant surgeon | $457.09 | $537.03 | $562.34 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $457.09 Median $537.03 Typical High $562.34 | Professional | 82 · Assistant surgeon, no resident | $457.09 | $537.03 | $562.34 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $389.05 Median $457.09 Typical High $478.63 | Professional | AS · PA/NP assist | $389.05 | $457.09 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,230.27 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,230.27 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $489.78 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,862.09 | $2,511.89 | $2,511.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $371.54 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $245.47 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,737.80 | $2,344.23 | $2,344.23 |
Where Idaho sits
The same service costs 6.9 times more in Alaska 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· 13th of 51
$3,090
AK $7,586TX $1,096
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.