How much rates vary
Facilitymedian $309 · 10th to 90th $93 to $1,318Professionalmedian $195 · 10th to 90th $145 to $275
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 $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $223.87 | Professional | None | $144.54 | $181.97 | $223.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $52.48 Median $524.81 Typical High $1,202.26 | Facility | None | $52.48 | $524.81 | $1,202.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $302.00 | Professional | None | $158.49 | $190.55 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $229.09 | Professional | None | $144.54 | $162.18 | $229.09 |
Moda Health Setting Facility Modifier None Typical Low $128.82 Median $218.78 Typical High $5,495.41 | Facility | None | $128.82 | $218.78 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $269.15 | Professional | None | $147.91 | $194.98 | $269.15 |
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 $138.04 Median $147.91 Typical High $239.88 | Facility | None | $138.04 | $147.91 | $239.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $281.84 | Professional | None | $147.91 | $173.78 | $281.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $891.25 Typical High $1,318.26 | Facility | None | $524.81 | $891.25 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $269.15 | Professional | None | $158.49 | $194.98 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $131.83 Typical High $151.36 | Facility | None | $125.89 | $131.83 | $151.36 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $177.83 | Professional | None | $131.83 | $131.83 | $177.83 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $114.82 Median $223.87 Typical High $323.59 | Professional | None | $114.82 | $223.87 | $323.59 |
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 $79.43 Median $79.43 Typical High $107.15 | Professional | 52 · Reduced service | $79.43 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | 53 · Discontinued | $31.62 | $31.62 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | 54 · Surgery only | $117.49 | $117.49 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $32.36 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $21.88 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $194.98 Typical High $281.84 | Professional | 54 · Surgery only | $147.91 | $194.98 | $281.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $18.62 Typical High $28.84 | Professional | 55 · Aftercare only | $15.85 | $18.62 | $28.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $186.21 Median $223.87 Typical High $331.13 | Professional | 63 · Small infant | $186.21 | $223.87 | $331.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $128.82 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $109.65 | $128.82 | $199.53 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $29.51 Typical High $50.12 | Professional | 80 · Assistant surgeon | $25.12 | $29.51 | $50.12 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $25.12 Median $30.90 Typical High $47.86 | Professional | 81 · Minimal assistant surgeon | $25.12 | $30.90 | $47.86 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $27.54 Median $29.51 Typical High $42.66 | Professional | 82 · Assistant surgeon, no resident | $27.54 | $29.51 | $42.66 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $21.38 Median $23.99 Typical High $41.69 | Professional | AS · PA/NP assist | $21.38 | $23.99 | $41.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | 52 · Reduced service | $79.43 | $79.43 | $107.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | 53 · Discontinued | $31.62 | $31.62 | $43.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | 54 · Surgery only | $117.49 | $117.49 | $162.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $32.36 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $32.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $21.88 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | 54 · Surgery only | $120.23 | $120.23 | $165.96 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $23.99 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $177.83 |
Where Idaho sits
The same service costs 11.5 times more in Connecticut than in Maryland. 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.
Physician feeFacility fee
CT $2,992MD $261
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.