How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,000 to $8,318Professionalmedian $912 · 10th to 90th $617 to $1,096
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 $1,202.26 Median $3,388.44 Typical High $8,709.64 | Facility | None | $1,202.26 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $1,000.00 Typical High $1,000.00 | Professional | None | $524.81 | $1,000.00 | $1,000.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $3,311.31 Typical High $8,511.38 | Facility | None | $2,187.76 | $3,311.31 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,023.29 | Professional | None | $831.76 | $977.24 | $1,023.29 |
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 $588.84 Median $676.08 Typical High $776.25 | Professional | None | $588.84 | $676.08 | $776.25 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $6,456.54 | Facility | None | $645.65 | $1,445.44 | $6,456.54 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,202.26 | Professional | None | $645.65 | $1,000.00 | $1,202.26 |
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 $741.31 Median $912.01 Typical High $912.01 | Facility | None | $741.31 | $912.01 | $912.01 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,148.15 | Professional | None | $912.01 | $912.01 | $1,148.15 |
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 $912.01 Median $1,000.00 Typical High $1,202.26 | Professional | None | $912.01 | $1,000.00 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $5,248.07 | Facility | None | $436.52 | $436.52 | $5,248.07 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $1,862.09 | Professional | None | $436.52 | $501.19 | $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 $537.03 Median $724.44 Typical High $1,047.13 | Professional | None | $537.03 | $724.44 | $1,047.13 |
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 $323.59 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $323.59 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $128.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $478.63 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $95.50 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $64.57 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $446.68 | $707.95 | $707.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $912.01 | Professional | 54 · Surgery only | $758.58 | $831.76 | $912.01 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $93.33 Typical High $102.33 | Professional | 55 · Aftercare only | $83.18 | $93.33 | $102.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,000.00 Median $1,122.02 Typical High $1,230.27 | Professional | 63 · Small infant | $1,000.00 | $1,122.02 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $588.84 | $660.69 | $707.95 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $147.91 Typical High $162.18 | Professional | 80 · Assistant surgeon | $134.90 | $147.91 | $162.18 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $134.90 Median $147.91 Typical High $162.18 | Professional | 81 · Minimal assistant surgeon | $134.90 | $147.91 | $162.18 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $134.90 Median $147.91 Typical High $162.18 | Professional | 82 · Assistant surgeon, no resident | $134.90 | $147.91 | $162.18 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $125.89 Typical High $138.04 | Professional | AS · PA/NP assist | $114.82 | $125.89 | $138.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $323.59 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $128.82 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $478.63 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $95.50 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $64.57 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $446.68 | $707.95 | $707.95 |
Where Idaho sits
The same service costs 4.5 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 $7,285MT $1,607
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.