How much rates vary
Facilitymedian $2,138 · 10th to 90th $741 to $8,913Professionalmedian $724 · 10th to 90th $468 to $1,023
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 $741.31 Median $933.25 Typical High $5,495.41 | Facility | None | $741.31 | $933.25 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $630.96 Typical High $776.25 | Professional | None | $389.05 | $630.96 | $776.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,089.30 Median $3,388.44 Typical High $9,772.37 | Facility | None | $2,089.30 | $3,388.44 | $9,772.37 |
BCBS Idaho Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,174.90 | Professional | None | $645.65 | $831.76 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $2,691.53 | Facility | None | $1,737.80 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $794.33 | Professional | None | $562.34 | $645.65 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $630.96 Median $3,801.89 Typical High $8,912.51 | Facility | None | $630.96 | $3,801.89 | $8,912.51 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,000.00 | Professional | None | $512.86 | $724.44 | $1,000.00 |
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 $724.44 Median $724.44 Typical High $1,023.29 | Facility | None | $724.44 | $724.44 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,096.48 | Professional | None | $724.44 | $891.25 | $1,096.48 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,165.95 Median $8,709.64 Typical High $12,589.25 | Facility | None | $6,165.95 | $8,709.64 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $851.14 | Professional | None | $645.65 | $794.33 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $537.03 Typical High $5,128.61 | Facility | None | $524.81 | $537.03 | $5,128.61 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $660.69 | Professional | None | $501.19 | $524.81 | $660.69 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $891.25 | Professional | None | $426.58 | $630.96 | $891.25 |
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 $257.04 Median $316.23 Typical High $389.05 | Professional | 52 · Reduced service | $257.04 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $125.89 Typical High $154.88 | Professional | 53 · Discontinued | $102.33 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $467.74 Typical High $588.84 | Professional | 54 · Surgery only | $380.19 | $467.74 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $93.33 Typical High $117.49 | Professional | 55 · Aftercare only | $77.62 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $63.10 Typical High $77.62 | Professional | 56 · Pre-op care only | $51.29 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $436.52 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $354.81 | $436.52 | $549.54 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,162.28 Median $5,011.87 Typical High $14,791.08 | Facility | 50 · Both sides | $3,162.28 | $5,011.87 | $14,791.08 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,412.54 Typical High $1,819.70 | Professional | 50 · Both sides | $1,071.52 | $1,412.54 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $891.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $645.65 | $891.25 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $89.13 Typical High $123.03 | Professional | 55 · Aftercare only | $70.79 | $89.13 | $123.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $851.14 Median $1,071.52 Typical High $1,412.54 | Professional | 63 · Small infant | $851.14 | $1,071.52 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $630.96 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $501.19 | $630.96 | $831.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $316.23 Typical High $389.05 | Professional | 52 · Reduced service | $269.15 | $316.23 | $389.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $125.89 Typical High $154.88 | Professional | 53 · Discontinued | $107.15 | $125.89 | $154.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $467.74 Typical High $588.84 | Professional | 54 · Surgery only | $398.11 | $467.74 | $588.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $93.33 Typical High $117.49 | Professional | 55 · Aftercare only | $79.43 | $93.33 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $63.10 Typical High $77.62 | Professional | 56 · Pre-op care only | $53.70 | $63.10 | $77.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $436.52 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $371.54 | $436.52 | $549.54 |
Where Idaho sits
The same service costs 7.2 times more in Vermont than in Maine. 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
VT $9,370ME $1,294
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.