How much rates vary
Facilitymedian $398 · 10th to 90th $112 to $977Professionalmedian $162 · 10th to 90th $85 to $398
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 $67.61 Median $147.91 Typical High $398.11 | Professional | None | $67.61 | $147.91 | $398.11 |
BCBS Idaho Setting Facility Modifier None Typical Low $257.04 Median $457.09 Typical High $630.96 | Facility | None | $257.04 | $457.09 | $630.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $107.15 Median $275.42 Typical High $398.11 | Professional | None | $107.15 | $275.42 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $177.83 Typical High $302.00 | Professional | None | $95.50 | $177.83 | $302.00 |
Hally Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $512.86 | Professional | None | $436.52 | $436.52 | $512.86 |
Moda Health Setting Facility Modifier None Typical Low $138.04 Median $398.11 Typical High $5,495.41 | Facility | None | $138.04 | $398.11 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $83.18 Median $162.18 Typical High $398.11 | Professional | None | $83.18 | $162.18 | $398.11 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $104.71 | Professional | None | $33.11 | $33.11 | $104.71 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $363.08 | Facility | None | $112.20 | $112.20 | $363.08 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $112.20 Median $213.80 Typical High $457.09 | Professional | None | $112.20 | $213.80 | $457.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $380.19 | Professional | None | $125.89 | $169.82 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $177.83 | Facility | None | $123.03 | $173.78 | $177.83 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $269.15 | Professional | None | $102.33 | $173.78 | $269.15 |
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 $74.13 Median $162.18 Typical High $331.13 | Professional | None | $74.13 | $162.18 | $331.13 |
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 $48.98 Median $69.18 Typical High $199.53 | Professional | 52 · Reduced service | $48.98 | $69.18 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $27.54 Typical High $79.43 | Professional | 53 · Discontinued | $19.50 | $27.54 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $104.71 Typical High $302.00 | Professional | 54 · Surgery only | $74.13 | $104.71 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $20.89 Typical High $60.26 | Professional | 55 · Aftercare only | $14.79 | $20.89 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $13.80 Typical High $39.81 | Professional | 56 · Pre-op care only | $9.77 | $13.80 | $39.81 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $489.78 Median $691.83 Typical High $954.99 | Facility | 50 · Both sides | $489.78 | $691.83 | $954.99 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $158.49 Median $512.86 Typical High $616.60 | Professional | 50 · Both sides | $158.49 | $512.86 | $616.60 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $302.00 Typical High $354.81 | Professional | 54 · Surgery only | $93.33 | $302.00 | $354.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.02 Typical High $38.90 | Professional | 55 · Aftercare only | $10.23 | $12.02 | $38.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $128.82 Median $151.36 Typical High $478.63 | Professional | 63 · Small infant | $128.82 | $151.36 | $478.63 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $87.10 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $72.44 | $87.10 | $288.40 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.60 Median $19.50 Typical High $63.10 | Professional | 80 · Assistant surgeon | $16.60 | $19.50 | $63.10 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.60 Median $44.67 Typical High $64.57 | Professional | 81 · Minimal assistant surgeon | $16.60 | $44.67 | $64.57 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.60 Median $19.95 Typical High $63.10 | Professional | 82 · Assistant surgeon, no resident | $16.60 | $19.95 | $63.10 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $14.13 Median $44.67 Typical High $54.95 | Professional | AS · PA/NP assist | $14.13 | $44.67 | $54.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $69.18 Typical High $199.53 | Professional | 52 · Reduced service | $69.18 | $69.18 | $199.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $79.43 | Professional | 53 · Discontinued | $27.54 | $27.54 | $79.43 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $302.00 | Professional | 54 · Surgery only | $104.71 | $104.71 | $302.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $60.26 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $60.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $39.81 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $39.81 |
Where Idaho sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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· 24th of 51
$174
NC $302IN $85.11
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.