How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,202 to $8,318Professionalmedian $1,072 · 10th to 90th $724 to $1,318
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 $1,258.93 Median $1,412.54 Typical High $5,495.41 | Facility | None | $1,258.93 | $1,412.54 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $1,202.26 Typical High $1,202.26 | Professional | None | $616.60 | $1,202.26 | $1,202.26 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $4,570.88 Typical High $8,511.38 | Facility | None | $2,187.76 | $4,570.88 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,202.26 | Professional | None | $1,000.00 | $1,174.90 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,754.23 | Facility | None | $1,819.70 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $912.01 | Professional | None | $691.83 | $812.83 | $912.01 |
Moda Health Setting Facility Modifier None Typical Low $870.96 Median $2,951.21 Typical High $8,511.38 | Facility | None | $870.96 | $2,951.21 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,412.54 | Professional | None | $758.58 | $1,202.26 | $1,412.54 |
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 $891.25 Median $1,071.52 Typical High $1,071.52 | Facility | None | $891.25 | $1,071.52 | $1,071.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,071.52 | $1,380.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $10,715.19 | Facility | None | $5,495.41 | $7,762.47 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,202.26 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $524.81 Typical High $5,248.07 | Facility | None | $512.86 | $524.81 | $5,248.07 |
Select Health Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $1,862.09 | Professional | None | $512.86 | $588.84 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,258.93 | Professional | None | $616.60 | $851.14 | $1,258.93 |
23 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 $380.19 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $380.19 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $151.36 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $575.44 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $114.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $75.86 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $537.03 | $831.76 | $831.76 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,311.31 Median $6,918.31 Typical High $12,589.25 | Facility | 50 · Both sides | $3,311.31 | $6,918.31 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,659.59 Typical High $1,819.70 | Professional | 50 · Both sides | $1,513.56 | $1,659.59 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,000.00 Typical High $1,096.48 | Professional | 54 · Surgery only | $891.25 | $1,000.00 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $112.20 Typical High $120.23 | Professional | 55 · Aftercare only | $100.00 | $112.20 | $120.23 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $691.83 Typical High $758.58 | Professional | 62 · Two surgeons | $630.96 | $691.83 | $758.58 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,202.26 Median $1,348.96 Typical High $1,445.44 | Professional | 63 · Small infant | $1,202.26 | $1,348.96 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $851.14 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $177.83 Typical High $194.98 | Professional | 80 · Assistant surgeon | $158.49 | $177.83 | $194.98 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $177.83 Typical High $194.98 | Professional | 81 · Minimal assistant surgeon | $158.49 | $177.83 | $194.98 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $177.83 Typical High $194.98 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $177.83 | $194.98 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $151.36 Typical High $165.96 | Professional | AS · PA/NP assist | $134.90 | $151.36 | $165.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $380.19 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $151.36 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $575.44 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $114.82 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $75.86 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $537.03 | $831.76 | $831.76 |
Where Idaho sits
The same service costs 3.9 times more in Wisconsin 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
WI $7,471MT $1,932
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.