How much rates vary
Facilitymedian $263 · 10th to 90th $78 to $501Professionalmedian $107 · 10th to 90th $63 to $302
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 $91.20 Median $309.03 Typical High $5,495.41 | Facility | None | $91.20 | $309.03 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $144.54 Typical High $263.03 | Professional | None | $48.98 | $144.54 | $263.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $85.11 Median $208.93 Typical High $371.54 | Facility | None | $85.11 | $208.93 | $371.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $74.13 Median $151.36 Typical High $346.74 | Professional | None | $74.13 | $151.36 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $102.33 Typical High $275.42 | Professional | None | $69.18 | $102.33 | $275.42 |
Moda Health Setting Facility Modifier None Typical Low $77.62 Median $239.88 Typical High $4,466.84 | Facility | None | $77.62 | $239.88 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $154.88 Typical High $331.13 | Professional | None | $61.66 | $154.88 | $331.13 |
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 $77.62 Median $77.62 Typical High $295.12 | Facility | None | $77.62 | $77.62 | $295.12 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $323.59 | Professional | None | $77.62 | $87.10 | $323.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $288.40 | Professional | None | $74.13 | $97.72 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $154.88 Typical High $295.12 | Facility | None | $151.36 | $154.88 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $151.36 Typical High $213.80 | Professional | None | $51.29 | $151.36 | $213.80 |
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 $54.95 Median $141.25 Typical High $288.40 | Professional | None | $54.95 | $141.25 | $288.40 |
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 $30.90 Median $38.90 Typical High $128.82 | Professional | 52 · Reduced service | $30.90 | $38.90 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $15.49 Typical High $52.48 | Professional | 53 · Discontinued | $12.30 | $15.49 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $57.54 Typical High $194.98 | Professional | 54 · Surgery only | $46.77 | $57.54 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $11.48 Typical High $38.90 | Professional | 55 · Aftercare only | $9.33 | $11.48 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.76 Typical High $26.30 | Professional | 56 · Pre-op care only | $6.17 | $7.76 | $26.30 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $81.28 Typical High $316.23 | Professional | 54 · Surgery only | $69.18 | $81.28 | $316.23 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.91 Typical High $34.67 | Professional | 55 · Aftercare only | $7.59 | $8.91 | $34.67 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $95.50 Median $354.81 Typical High $416.87 | Professional | 63 · Small infant | $95.50 | $354.81 | $416.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $63.10 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $53.70 | $63.10 | $251.19 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.30 Median $14.45 Typical High $54.95 | Professional | 80 · Assistant surgeon | $12.30 | $14.45 | $54.95 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.30 Median $14.45 Typical High $57.54 | Professional | 81 · Minimal assistant surgeon | $12.30 | $14.45 | $57.54 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.30 Median $14.79 Typical High $56.23 | Professional | 82 · Assistant surgeon, no resident | $12.30 | $14.79 | $56.23 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $10.47 Median $12.30 Typical High $47.86 | Professional | AS · PA/NP assist | $10.47 | $12.30 | $47.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $38.90 Typical High $128.82 | Professional | 52 · Reduced service | $30.90 | $38.90 | $128.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $15.49 Typical High $52.48 | Professional | 53 · Discontinued | $12.30 | $15.49 | $52.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $57.54 Typical High $194.98 | Professional | 54 · Surgery only | $46.77 | $57.54 | $194.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $11.48 Typical High $38.90 | Professional | 55 · Aftercare only | $9.33 | $11.48 | $38.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.76 Typical High $26.30 | Professional | 56 · Pre-op care only | $6.17 | $7.76 | $26.30 |
Where Idaho sits
The same service costs 13.8 times more in Hawaii than in Louisiana. 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
HI $2,918LA $212
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.