How much rates vary
Facilitymedian $692 · 10th to 90th $155 to $2,692Professionalmedian $324 · 10th to 90th $110 to $708
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 $154.88 Median $691.83 Typical High $5,495.41 | Facility | None | $154.88 | $691.83 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $371.54 Typical High $602.56 | Professional | None | $87.10 | $371.54 | $602.56 |
BCBS Idaho Setting Facility Modifier None Typical Low $186.21 Median $1,122.02 Typical High $2,290.87 | Facility | None | $186.21 | $1,122.02 | $2,290.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $125.89 Median $562.34 Typical High $741.31 | Professional | None | $125.89 | $562.34 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $660.69 | Professional | None | $120.23 | $181.97 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $758.58 Typical High $5,754.40 | Facility | None | $131.83 | $758.58 | $5,754.40 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $380.19 Typical High $660.69 | Professional | None | $107.15 | $380.19 | $660.69 |
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 $131.83 Median $131.83 Typical High $630.96 | Facility | None | $131.83 | $131.83 | $630.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $131.83 Median $257.04 Typical High $676.08 | Professional | None | $131.83 | $257.04 | $676.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $2,290.87 | Facility | None | $1,202.26 | $1,737.80 | $2,290.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $707.95 | Professional | None | $125.89 | $165.96 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $323.59 Median $331.13 Typical High $2,951.21 | Facility | None | $323.59 | $331.13 | $2,951.21 |
Select Health Setting Professional Modifier None Typical Low $89.13 Median $323.59 Typical High $446.68 | Professional | None | $89.13 | $323.59 | $446.68 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $95.50 Median $371.54 Typical High $812.83 | Professional | None | $95.50 | $371.54 | $812.83 |
20 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 $52.48 Median $66.07 Typical High $302.00 | Professional | 52 · Reduced service | $52.48 | $66.07 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $26.30 Typical High $120.23 | Professional | 53 · Discontinued | $21.38 | $26.30 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $97.72 Typical High $446.68 | Professional | 54 · Surgery only | $79.43 | $97.72 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.95 Typical High $89.13 | Professional | 55 · Aftercare only | $15.85 | $19.95 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.18 Typical High $60.26 | Professional | 56 · Pre-op care only | $10.72 | $13.18 | $60.26 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $281.84 Median $1,698.24 Typical High $3,467.37 | Facility | 50 · Both sides | $281.84 | $1,698.24 | $3,467.37 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $234.42 Typical High $1,148.15 | Professional | 50 · Both sides | $194.98 | $234.42 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $549.54 Typical High $660.69 | Professional | 54 · Surgery only | $131.83 | $549.54 | $660.69 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $15.49 Typical High $74.13 | Professional | 55 · Aftercare only | $13.18 | $15.49 | $74.13 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $158.49 Median $186.21 Typical High $891.25 | Professional | 63 · Small infant | $158.49 | $186.21 | $891.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $107.15 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $91.20 | $107.15 | $512.86 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $21.88 Median $25.70 Typical High $117.49 | Professional | 80 · Assistant surgeon | $21.88 | $25.70 | $117.49 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $20.42 Median $24.55 Typical High $123.03 | Professional | 81 · Minimal assistant surgeon | $20.42 | $24.55 | $123.03 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.88 Median $97.72 Typical High $123.03 | Professional | 82 · Assistant surgeon, no resident | $21.88 | $97.72 | $123.03 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $20.89 Typical High $97.72 | Professional | AS · PA/NP assist | $17.38 | $20.89 | $97.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $66.07 Typical High $302.00 | Professional | 52 · Reduced service | $52.48 | $66.07 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $26.30 Typical High $120.23 | Professional | 53 · Discontinued | $21.38 | $26.30 | $120.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $97.72 Typical High $446.68 | Professional | 54 · Surgery only | $79.43 | $97.72 | $446.68 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.95 Typical High $89.13 | Professional | 55 · Aftercare only | $15.85 | $19.95 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.18 Typical High $60.26 | Professional | 56 · Pre-op care only | $10.72 | $13.18 | $60.26 |
Where Idaho sits
The same service costs 5.5 times more in Connecticut than in Montana. 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 $3,114MT $570
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.