How much rates vary
Facilitymedian $550 · 10th to 90th $85 to $1,549Professionalmedian $162 · 10th to 90th $102 to $200
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 $95.50 Median $162.18 Typical High $186.21 | Professional | None | $95.50 | $162.18 | $186.21 |
BCBS Idaho Setting Facility Modifier None Typical Low $48.98 Median $524.81 Typical High $1,202.26 | Facility | None | $48.98 | $524.81 | $1,202.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $199.53 | Professional | None | $158.49 | $169.82 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $181.97 | Professional | None | $128.82 | $158.49 | $181.97 |
Hally Health Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $436.52 | Professional | None | $281.84 | $281.84 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $776.25 Typical High $5,495.41 | Facility | None | $144.54 | $776.25 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $204.17 | Professional | None | $95.50 | $162.18 | $204.17 |
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 $128.82 Median $154.88 Typical High $154.88 | Facility | None | $128.82 | $154.88 | $154.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $177.83 | Professional | None | $154.88 | $154.88 | $177.83 |
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 $144.54 Median $162.18 Typical High $204.17 | Professional | None | $144.54 | $162.18 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $85.11 Median $87.10 Typical High $151.36 | Facility | None | $85.11 | $87.10 | $151.36 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $173.78 | Professional | None | $85.11 | $123.03 | $173.78 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $8,317.64 Typical High $9,332.54 | Facility | None | $1,862.09 | $8,317.64 | $9,332.54 |
United Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $204.17 | Professional | None | $112.20 | $154.88 | $204.17 |
18 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 $66.07 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $66.07 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $26.30 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $97.72 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $19.50 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $13.18 | $16.22 | $16.22 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $165.96 Typical High $181.97 | Professional | 54 · Surgery only | $144.54 | $165.96 | $181.97 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $18.62 Typical High $19.95 | Professional | 55 · Aftercare only | $15.85 | $18.62 | $19.95 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $190.55 Median $223.87 Typical High $239.88 | Professional | 63 · Small infant | $190.55 | $223.87 | $239.88 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $128.82 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $112.20 | $128.82 | $141.25 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.70 Median $29.51 Typical High $32.36 | Professional | 80 · Assistant surgeon | $25.70 | $29.51 | $32.36 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $25.70 Median $29.51 Typical High $32.36 | Professional | 81 · Minimal assistant surgeon | $25.70 | $29.51 | $32.36 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $25.70 Median $29.51 Typical High $32.36 | Professional | 82 · Assistant surgeon, no resident | $25.70 | $29.51 | $32.36 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $21.38 Median $25.12 Typical High $27.54 | Professional | AS · PA/NP assist | $21.38 | $25.12 | $27.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $66.07 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $26.30 | $32.36 | $32.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $100.00 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $19.95 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $13.18 | $16.22 | $16.22 |
Where Idaho sits
The same service costs 3.5 times more in Wisconsin than in New York. 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· 16th of 51
$162
WI $316NY $89.13
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.